Philadelphia 'Scoop and Run' penetrating trauma victims studied over 5-year period
A new study from the Perelman School of Medicine at the University of Pennsylvania has found no significant difference in adjusted overall survival rates between gunshot and stabbing (so-called penetrating trauma injuries) victims in Philadelphia whether they were transported to the emergency department by the police department or the emergency medical services (EMS) division of the fire department.
"This study is an examination of current prehospital practices with an eye toward improving patient care and is by no means intended as a criticism of the highly trained and dedicated professionals of the Philadelphia Fire Department who provide outstanding care under difficult circumstances," said lead author Roger Band, MD, assistant professor of Emergency Medicine at the Hospital of the University of Pennsylvania. "The Fire Department, the Police Department, and health care professionals all share the same goal: learn all we can in order to continually improve the care and services we provide to patients and the community."
The study, published online ahead of print in the Annals of Emergency Medicine, examined 4,122 patients taken to eight Level I and Level II adult trauma centers in Philadelphia between January 1, 2003 and December 31, 2007. Of these, 2,961 were transported by EMS and 1,161 by the police. The overall mortality rate was 27.4 percent. Just over three quarters (77.9 percent) of the victims suffered gunshot wounds, and just under a quarter (22.1 percent) suffered stab wounds. The majority of patients in both groups (84.1 percent) had signs of life on delivery to the hospital. A third of patients with gunshot wounds (33.0 percent) died compared with 7.7 percent of patients with stab wounds.
Although patients transported by the police department were more likely to die compared with those transported by EMS (29.8 percent versus 26.5 percent), these findings appear to be explained by the more severely injured population that the police typically transport to the hospital and not the mode of transport itself.
The Penn study also found that severely injured gunshot victims transported by the police were more likely to survive. "There could be many factors contributing to this finding, such as the fact that police may have shorter response times to an event simply by virtue of how they patrol," said Band.
While previous studies suggest that trauma victims have similar mortality rates whether brought to the hospital by emergency medical services or police, the current Penn study is the largest investigation to date examining the relationship between method of transport and mortality in penetrating trauma.