The Factors Affecting the Precaution and Request of Medical Direction for Prehospital Emergency Treatment of Major Trauma Patients by 119 Rescue Services

ABSTRACT

PURPOSE: This study examined the factors affecting the precaution and request of medical direction for prehospital emergency treatment of major trauma patients by 119 rescue services. METHODS: Medical records and prehospital run reports of major trauma patients with an Injury Severity Score (ISS) above 15 were reviewed. In total, 123 patients who were transferred by 119 rescue services to the Emergency Department of one hospital from December 1, 2010 to February 28, 2013 were enrolled. A total of 123 patients with major trauma satisfied the ISS criterion. Excluding 26 patients with missing data, 97 patients were included in this study. Out of these 97 patients, 72 patients were male and the mean age was 46+/-16.1 years. The statistical methods used in the analysis were the Receiver-Operating Characteristic curve and Fisher's exact test. RESULTS: Between the hospital precaution group and non-precaution group, the only significant difference was in the RTS score (p=0.007). In total, 52 patients (39 male patients; mean age 49.52+/-16.14 years) with major trauma were transferred during the medical direction period. Between groups that requested medical direction and groups that did not, the only significant difference was the time interval from the call to hospital arrival (p=0.032). CONCLUSION: Within the variables we examined, transport of major trauma patients, in addition to low incidence of precaution and request for medical direction by 119 rescue services, only a few were considered.