Distribution of Prehospital Times of Major Trauma Cases Attended by Emergency Medical Services in Aotearoa New Zealand

Abstract

Aims: Co-ordinated trauma systems ensure timely transport to the appropriate hospital for patients following acute trauma. The Aotearoa New Zealand National Trauma Network reports median transport times to definitive care annually but omits reporting specific prehospital time intervals. This study focusses on prehospital times for major trauma patients attended by emergency medical services (EMS) in Aotearoa New Zealand.

Methods: An analysis of routinely collected data from a retrospectively designed prospective cohort study was undertaken. Individuals of any age who suffered major trauma (Injury Severity Score [ISS] greater than 12 or died) between 2016 and 2018 and were attended by an EMS provider were included. Descriptive analyses were performed.

Results: A total of 3,334 patients met the eligibility criteria, of which 105 (3.1%) died prehospital and 121 (3.6%) died within 24 hours following hospital admission. Response time was significantly faster for patients who died prehospital (median 11.5 minutes cf 14.5 minutes for those that survived to the hospital; p=0.0002). Among hospitalised patients, the median total prehospital time was 80.6 minutes (interquartile range [IQR]: 55.2–114.0). Patients who died within 24 hours following admission had significantly faster response and transport times (p=0.0005 and 0.009 respectively).

Conclusion: This study is the first to map out the distribution of prehospital times for major trauma patients in Aotearoa New Zealand. It establishes a crucial baseline for the timeliness of EMS care and shines a light on the significant sex and ethnic disparities among those affected by major trauma.