TY  - JOUR
PY  - 2007//
TI  - Emergency Medical Service (EMS) systems in developed and developing countries
JO  - Injury
A1  - Koepsell, Thomas D.
A1  - Gruen, Russell L.
A1  - Grigoriou, Giouli
A1  - Civil, I.
A1  - Cameron, Peter
A1  - Arreola-Rissa, Carlos
A1  - Nathens, Avery B.
A1  - Roudsari, Bahman S.
A1  - Petridou, Eleni
A1  - Oestern, H. J.
A1  - Mock, Charles N.
A1  - Rivara, Frederick P.
A1  - Zargar, Mousa
A1  - Waydhas, C.
A1  - Schildhauer, Thomas A.
A1  - Liberman, Moishe
A1  - Lefering, Rolf L.
A1  - Lecky, Fiona E.
SP  - 1001
EP  - 1101
VL  - 38
IS  - 9
N2  - OBJECTIVES: To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. METHOD: We collated de-identified patient-level data from national or local trauma registries in Australia, Austria, Canada, Greece, Germany, Iran, Mexico, New Zealand, the Netherlands, the United Kingdom and the United States. Patient and injury-related characteristics of trauma victims with injury severity score (ISS) >15 and the pre-hospital trauma care provided to these patients were compared among different countries. RESULTS: A total of 30,339 subjects from one or several regions in 11 countries were included in this analysis. Austria (51%), Germany (41%) and Australia (30%) reported the highest proportion of air ambulance use. Monterrey, Mexico (median 10.1min) and Montreal, Canada (median 16.1min) reported the shortest and Germany (median: 30min) and Austria (median: 26min) reported the longest scene time. Use of intravenous fluid therapy among advanced EMS systems without physicians as pre-hospital care providers, varied from 30% (in the Netherlands) to 55% (in the US). The corresponding percentages in advanced EMS systems with physicians actively involved in pre-hospital trauma care, excluding Montreal in Canada, ranged from 63% (in London, in the UK) to 75% in Germany and Austria. Austria and Germany also reported the highest percentage of pre-hospital intubation (61% and 56%, respectively). CONCLUSION: This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients.<p />  <p>Language: en</p>
LA  - en
SN  - 0020-1383
UR  - http://dx.doi.org/10.1016/j.injury.2007.04.008
ID  - ref1
ER  -