A traumatic tale of two cities: does EMS level of care and transportation model affect survival in patients with trauma at level 1 trauma centres in two neighbouring Canadian provinces?

Emergency Medicine Journal : EMJ
Colin RousePaul Atkinson

Abstract

Two distinct Emergency Medical Services (EMS) systems exist in Atlantic Canada. Nova Scotia operates an Advanced Emergency Medical System (AEMS) and New Brunswick operates a Basic Emergency Medical System (BEMS). We sought to determine if survival rates differed between the two systems. This study examined patients with trauma who were transported directly to a level 1 trauma centre in New Brunswick or Nova Scotia between 1 April 2011 and 31 March 2013. Data were extracted from the respective provincial trauma registries; the lowest common Injury Severity Score (ISS) collected by both registries was ISS≥13. Survival to hospital and survival to discharge or 30 days were the primary endpoints. A separate analysis was performed on severely injured patients. Hypothesis testing was conducted using Fisher's exact test and the Student's t-test. 101 cases met inclusion criteria in New Brunswick and were compared with 251 cases in Nova Scotia. Overall mortality was low with 93% of patients surviving to hospital and 80% of patients surviving to discharge or 30 days. There was no difference in survival to hospital between the AEMS (232/251, 92%) and BEMS (97/101, 96%; OR 1.98, 95% CI 0.66 to 5.99; p=0.34) groups. Furthermore, when compari...Continue Reading

References

Jun 19, 1987·JAMA : the Journal of the American Medical Association·W G Baxt, P Moody
Apr 26, 2000·The Journal of Trauma·M EcksteinR Palmer
Oct 5, 2001·The Journal of Trauma·S Di BartolomeoL Lattuada
Feb 1, 2003·Annals of Surgery·Moishe LibermanJohn S Sampalis
Jun 5, 2004·The Journal of Trauma·Saman ArbabiRonald V Maier
Sep 1, 2005·Prehospital and Disaster Medicine·Derek L Isenberg, Richard Bissell
Nov 24, 2005·Emergency Medicine Australasia : EMA·Nathan BushbyMichael Bailey
Apr 23, 2008·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Ian G StiellUNKNOWN OPALS Study Group
Jun 24, 2008·Bulletin of the World Health Organization·Charles MockEtienne Krug
Nov 26, 2010·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Olli-Pekka RyynänenAntti Malmivaara
Apr 24, 2013·The Journal of Trauma and Acute Care Surgery·Lynne MooreAlexis F Turgeon
Sep 28, 2013·Emergency Medicine Journal : EMJ·Johannes von Vopelius-FeldtJonathan Benger
May 29, 2015·Arab Journal of Urology·Issam S Al-Azzawi, Mamdouh M Koraitim
Jul 29, 2015·The Journal of Trauma and Acute Care Surgery·Jonathan P MeizosoKenneth G Proctor
Oct 13, 2015·Annals of Internal Medicine·Prachi SanghaviAlan M Zaslavsky

❮ Previous
Next ❯

Citations

Jan 28, 2020·International Journal of Injury Control and Safety Promotion·Mathew Varghese
Dec 12, 2020·Trauma Surgery & Acute Care Open·Sara F JacobyElinore J Kaufman

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.