Factors associated with EMS on-scene time and its regional difference in road traffic injuries: a population-based observational study

Abstract

Background The outcome of road traffic injury (RTI) is determined by duration of prehospital time, patient’s demographics, and the type of injury and its mechanism. During the emergency medical service (EMS) prehospital time interval, on-scene time should be minimized for early treatment. This study aimed to examine the factors influencing on-scene EMS time among RTI patients. Methods We evaluated 19,141 cases of traffic trauma recorded between April 2014 and March 2020 in the EMS database of the Nara Wide Area Fire Department and the prehospital database of the emergency Medical Alliance for Total Coordination of Healthcare (e-MATCH). To examine the association of the number of EMS phone calls until hospital acceptance, age ≥65 years, high-risk injury, vital signs, holiday, and nighttime (0:00–8:00) with on-scene time, a generalized linear mixed model with random effects for four study regions was conducted. Results EMS phone calls were the biggest factor, accounting for 5.69 minutes per call, and high-risk injury accounted for an additional 2.78 minutes. Holiday, nighttime, and age ≥65 years were also associated with increased on-scene time, but there were no significant vital sign variables for on-scene time, except for the level of consciousness. Regional differences were also noted based on random effects, with a maximum difference of 2 minutes among regions. Conclusions The number of EMS phone calls until hospital acceptance was the most significant influencing factor in reducing on-scene time, and high-risk injury accounted for up to an additional 2.78 minutes. Considering these factors, including regional differences, can help improve the regional EMS policies and outcomes of RTI patients.

Factors associated with prolonged on-scene time in ambulance transportation among patients with minor diseases or injuries in Japan: a population-based observational study

“…The finding that the number of hospital inquiries ≥ 4 was significantly associated with prolonged OSTs is consistent with several Japanese studies [ 13 , 16 , 34 – 35 ]. Making request calls to hospitals until the patients are accepted is unique to the Japanese emergency system.…”

“…Previous studies have reported the following factors related to prolonged OSTs: older age, female sex, blunt trauma, nighttime, and holidays in patients with trauma [ 7 , 13 , 14 ], and older age, female sex, minor diseases, intoxication, winter season, hospital type, and geographical areas in those with critical medical conditions [ 15 , 16 ]. However, factors related to prolonged OSTs in patients with minor diseases or injuries remain unclear.…”