Issn Print: 1079-6061

Publication Date: 1999/09/01


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A MULTI-CENTRE CANADIAN STUDY OF PRE-HOSPITAL TRAUMA CARE: A TALE OF THREE CITIES.

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Excerpt

The debate surrounding urban pre-hospital trauma care is ongoing. As a result, there exists variation with respect to the type of pre-hospital care that is provided to patients with major trauma. In Canada, the type of on-site care available to patients with major trauma is geographically dependent and varies from physician provided Advanced Life Support (MD-ALS), paramedic provided Advanced Life Support (PMD-ALS), and Emergency Medical Technician provided Basic Life Support (EMT-BLS).
The current study used an observational design to compare the outcome of trauma patients treated at tertiary (level I) trauma centres from three cities with different type of pre-hospital care. The study was based on 3,180 patients from Toronto where PMD-ALS is available, 10,252 patients from Montreal where MD-ALS is available and 2,477 patients from Québec City where EMT-ALS is available. The distribution of demographics, mechanism of injury, and injury severity was similar for the three cohorts. The following table summarizes the mortality rates (%) by ISS category.
These results suggest that the Scoop and Run approach with only Basic Life Support (BLS) provided at the scene may be the most efficient method for the pre-hospital management of urban trauma. Paramedic provided on-site care may be more efficient than physicians at the scene.
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