Prehospital transportation of severe penetrating trauma victims in Sweden during the past decade: a police business?

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Original Research

Amir Rostami¹  Mattias Renberg²  Mattias Günther³  Mikael Gellerfors⁴  Martin Dahlberg⁵  Elham Rostami⁶ 

[1] Department for Social Work and Criminology, University of Gävle, Gävle, Sweden;Department of Anesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden;Department of Anesthesiology and Intensive Care, Södersjukhuset, Stockholm, Sweden;Experimental Traumatology Unit, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden;Department of Clinical Science and Education, Section for Anesthesiology and Intensive Care, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, S1, 118 83, Stockholm, Sweden;Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden;Rapid Response Car, Capio, Stockholm, Sweden;Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden;Swedish Air Ambulance (SLA), Mora, Sweden;Department of Surgery, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden;Experimental Traumatology Unit, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden;Department of Medical Sciences, Section of Neurosurgery, Uppsala University Hospital, Uppsala, Sweden;

关键词: Penetrating trauma;    Trauma;    Police;    Prehospital;    Private vehicle;   

DOI  :  10.1186/s13049-023-01112-x

 received in 2023-08-23, accepted in 2023-09-03,  发布年份 2023

来源: Springer

【 摘 要 】

IntroductionSweden is facing a surge of gun violence that mandates optimized prehospital transport approaches, and a survey of current practice is fundamental for such optimization. Management of severe, penetrating trauma is time sensitive, and there may be a survival benefit in limiting prehospital interventions. An important aspect is unregulated transportation by police or private vehicles to the hospital, which may decrease time but may also be associated with adverse outcomes. It is not known whether transport of patients with penetrating trauma occurs outside the emergency medical services (EMS) in Sweden and whether it affects outcome.MethodThis was a retrospective, descriptive nationwide study of all patients with penetrating trauma and injury severity scores (ISSs) ≥ 15 registered in the Swedish national trauma registry (SweTrau) between June 13, 2011, and December 31, 2019. We hypothesized that transport by police and private vehicles occurred and that it affected mortality.ResultA total of 657 patients were included. EMS transported 612 patients (93.2%), police 10 patients (1.5%), and private vehicles 27 patients (4.1%). Gunshot wounds (GSWs) were more common in police transport, 80% (n = 8), compared with private vehicles, 59% (n = 16), and EMS, 32% (n = 198). The Glasgow coma scale score (GCS) in the emergency department (ED) was lower for patients transported by police, 11.5 (interquartile range [IQR] 3, 15), in relation to EMS, 15 (IQR 14, 15) and private vehicles 15 (IQR 12.5, 15). The 30-day mortality for EMS was 30% (n = 184), 50% (n = 5) for police transport, and 22% (n = 6) for private vehicles. Transport by private vehicle, odds ratio (OR) 0.65, (confidence interval [CI] 0.24, 1.55, p = 0.4) and police OR 2.28 (CI 0.63, 8.3, p = 0.2) were not associated with increased mortality in relation to EMS.ConclusionNon-EMS transports did occur, however with a low incidence and did not affect mortality. GSWs were more common in police transport, and victims had lower GCS scorescores when arriving at the ED, which warrants further investigations of the operational management of shooting victims in Sweden.

【 授权许可】

CC BY   
© Norwegian Air Ambulance Foundation 2023

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