Police transport versus ground EMS

Wandling, Michael W.; Nathens, Avery B.; Shapiro, Michael B.; Haut, Elliott R.

doi:10.1097/ta.0000000000001228

Cited by 63 publications

(66 citation statements)

References 16 publications

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“…This finding is possibly consistent with evidence that traffic accident victims in Tanzania who are transported to the ED are significantly more likely to die when transported in police vehicles than those transported by other vehicles [ 7 ]. A comparison may be made to a study conducted in the United States showing that trauma victims transported to the ED in law enforcement vehicles were no more likely to die than those transported in emergency medical service vehicles [ 23 , 24 ]. In the present study, even though more than half of the surveyed traffic police officers had previous first aid training, only one out of every 57 officers displayed a high level of knowledge about post-crash first aid.…”

Section: Discussionmentioning

confidence: 99%

Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey

et al. 2018

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BackgroundThe availability of prehospital trauma care is an important means of reducing serious injuries and fatalities associated with road traffic injuries (RTIs). Lay responders such as traffic police play an important role in the provision of prehospital trauma care to RTI victims, especially where there is no established prehospital care system. Therefore, the objective of the present study was to investigate knowledge, self-reported practice, and attitudes toward post-crash first aid among traffic police officers in Tanzania.MethodA cross-sectional survey was conducted in Dar es Salaam, Tanzania between July–September 2017 to investigate knowledge, self-reported practice and attitude among traffic police officers during provision of post-crash care. We used simple random technique to recruit 340 traffic police officers, self -administered questionnaires were used to collect data. The researchers used descriptive statistics and Pearson’s chi-square tests to analyze the data.ResultsA total of 340 traffic police officers were surveyed. Nearly two thirds (65.3%) reported having had post-crash first aid on-the job training; a slightly larger proportion (70.9%) reported that they had cared for RTI victims in the previous year. The survey responses showed that, generally, traffic police officers’ level of knowledge about post-crash first aid to RTI victims was low—about 3% of the surveyed officers possessed knowledge at a level considered good. Also, there was a statistically significant correlation between higher educational attainment and greater knowledgeability (p = 0.015). Almost all of the officers (96%) had a positive attitude toward providing post-crash first aid to RTI victims.ConclusionsImproved training of Tanzania traffic police officers, by means of an updated post-crash first aid curriculum and updated resources is recommended. Also, user-friendly post-crash first aid leaflets should be provided to traffic police for their reference.Electronic supplementary materialThe online version of this article (10.1186/s12873-018-0199-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey

et al. 2018

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“…However, some participants experienced police transport as dangerous or painful, and one participant’s distrust of police led him to refuse this form of transport entirely. Although police transport is rare in the U.S., and nearly 90% of cases occur in just three cities (Philadelphia, Sacramento, and Detroit), this strategy may appeal to policymakers striving to improve trauma care (Wandling et al, 2016). Cities with similar policies and those considering adopting police transport to improve trauma outcomes should evaluate the racialized and psychological dimensions of these policies.…”

Section: Discussionmentioning

confidence: 99%

A safe haven for the injured? Urban trauma care at the intersection of healthcare, law enforcement, and race

Jacoby

Richmond

Holena

et al. 2018

Social Science & Medicine

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Patients with traumatic injuries often interact with police before and during hospitalization, particularly when their injuries are due to violence. People of color are at highest risk for violent injuries and have the poorest outcomes after injury. The purpose of this study was to describe how injured, Black patients perceived their interactions with police and what these perceptions reveal about police involvement within trauma care systems. We combined data from two qualitative studies to achieve this aim. The first was ethnographic fieldwork that followed Black trauma patients in the hospital through the physical and emotional aftermath of their injuries. The second was a qualitative, descriptive study of how patients experienced trauma resuscitation in the emergency department (ED). Both studies were conducted between 2012 and 2015 at the Trauma Center at Penn, an academic medical center in Philadelphia, Pennsylvania, United States. The present study includes data from 24 adult, Black participants undergoing treatment for injury. We reanalyzed all interview data related to law enforcement encounters from the scene of injury through inpatient hospitalization and coded data using a constant comparative technique from grounded theory. Participants described law enforcement encounters at the scene of injury and during transport to the hospital, in the ED, and over the course of inpatient care. Injured participants valued police officers' involvement when they perceived that officers provided safety at the scene, speed of transport to the hospital, or support and information after injury. Injured participants also found police questioning to be stressful and, at times, disrespectful or conflicting with clinical care. Communities, trauma centers, and professional societies have the opportunity to enact policies that standardize law enforcement access in trauma centers and balance patients' health, privacy, and legal rights with public safety needs.

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“…1,2 Proponents of prehospital intervention argue that the advanced training of prehospital providers may save lives by allowing early treatment of potentially life-threatening conditions such as unstable airways 3 and external hemorrhage and may prevent exacerbation of injuries such as spinal cord and vertebral column injuries. 4 Supporters of prehospital transport without interventions argue that although interventions such as intubation, intravenous line placement, and fluid administration aim to stabilize injured patients in the field, their cost in increased transit time to definitive care might outweigh their benefit.…”

Section: Introductionmentioning

confidence: 99%

“…8 The two studies of this practice have found that penetrating trauma patients had equivalent outcomes when transported by police relative to EMS. 1,9,10 While the focus has been on penetrating trauma, increased use of police transport (PT) may lead to bluntly injured patients being transported by police as well. Bluntly injured patients may have multiple injuries that are difficult for non-medical providers on scene to identify, and transport without stabilization could exacerbate their injuries.…”

Section: Introductionmentioning

confidence: 99%

Patient Characteristics and Temporal Trends in Police Transport of Blunt Trauma Patients: A Multicenter Retrospective Cohort Study

Kaufman¹,

Jacoby²,

Sharoky³

et al. 2017

Prehospital Emergency Care

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Background Police transport (PT) of penetrating trauma patients has the potential to decrease prehospital times for patients with life-threatening hemorrhage and is part of official policy in Philadelphia, Pennsylvania. We hypothesized that rates of PT of bluntly injured patients have increased over the past decade. Methods We used Pennsylvania Trauma Outcomes Study registry data from 2006–15 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia. PT was compared to ambulance transport, excluding transfers, burn patients, and private transport. We compared demographics, mechanism, and injury outcomes between PT and ambulance transport patients and used multivariable logistic regression to identify independent predictors of PT. We also identified physiological indicators and injury patterns that might have benefitted from prehospital intervention by EMS. Results Of 28 897 bluntly injured patients, 339 (1.2%) were transported by police and 28 558 (98.8%) by ambulance. Blunt trauma accounted for 11% of PT and penetrating trauma for 89%. PT patients were younger, more likely to be male, and more likely to be African American or Asian and were more often injured by assault or motor vehicle crash. There were no significant differences presenting physiology between PT and EMS patients. In multivariable logistic regression analysis, male sex (OR 1.89, 95%CI 1.40–2.55), African American race (OR 1.71 95%CI 1.34–2.18), and Asian race (OR 2.25, 95%CI 1.22–4.14) were independently associated with PT. Controlling for injury severity and physiology, there was no significant difference in mortality between PT and EMS. Overall, 64% of PT patients had a condition that might have benefited from prehospital intervention such as supplemental oxygen for brain injury or spine stabilization for vertebral fractures. Conclusions PT affects a small minority of blunt trauma patients, and did not appear associated with higher mortality. However, PT patients included many who might have benefited from proven, prehospital intervention. Clinicians, EMS providers, and law enforcement should collaborate to optimize use of PT within the trauma system.

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Police transport versus ground EMS

Abstract: Prognostic/epidemiologic study, level III.

Cited by 63 publications

References 16 publications

Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey

Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey

A safe haven for the injured? Urban trauma care at the intersection of healthcare, law enforcement, and race

Patient Characteristics and Temporal Trends in Police Transport of Blunt Trauma Patients: A Multicenter Retrospective Cohort Study

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