Association between Mode of Transportation and Survival in Adult Trauma Patients with Penetrating Injuries: Matched Cohort Study between Police and Ground Ambulance Transport

Abstract

Introduction: Police transport (PT) of penetrating trauma patients has the potential to improve survival rates. There are no well-established guidelines for PT of penetrating trauma patients. Study Objective: This study examines the association between survival rate to hospital discharge of adult penetrating trauma patients and mode of transport (PT versus ground ambulance [GA]). Methods: A retrospective, matched cohort study was conducted using the United States (US) National Trauma Data Bank (NTDB). All adult penetrating injury patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by GA for analysis. Descriptive analysis was carried out. The patients’ demographic and clinical characteristics were tabulated and stratified by the transport mode. Results: Out of the 733 patients with penetrating injuries, ground Emergency Medical Services (EMS) transported 513 patients and police transported 220 patients. Most patients were 16-64 years of age with a male (95.6%) and Black/African American race (79.0%) predominance. Firearm-related injuries (68.8%) were the most common mechanism of injury with the majority of injuries involving the body extremities (62.9%). Open wounds were the most common nature of injury (75.7%). The overall survival rate to hospital discharge was similar for patients transported by GA and by police (94.5% versus 92.7%; P = .343). Conclusion: In this study, patients with penetrating trauma transported by police had similar outcomes to those transported by GA. As such, PT in penetrating trauma appears to be effective. Detailed protocols should be developed to further improve resource utilization and outcomes.

How do current police practices impact trauma care in the prehospital setting? A scoping review

“…Of these, 8 articles evaluated transport for penetrating trauma, 2 articles evaluated transport for blunt trauma, and 1 article evaluated both. No differences were found in mortality between EMS or police transport 20–24 . One study estimated that 64% of patients transported by police in Philadelphia may have benefited from prehospital interventions typically provided by EMS, such as intravenous fluids, spinal immobilization, or endotracheal intubation 25 …”

“…No differences were found in mortality between EMS or police transport. [20][21][22][23][24] One study estimated that 64% of patients transported by police in Philadelphia may have benefited from prehospital interventions typically provided by EMS, such as intravenous fluids, spinal immobilization, or endotracheal intubation. 25 Qualitative work involving Black trauma patients transported by police observed mixed responses.…”