Trauma Incidents Attended by Emergency Medical Services in Victoria, Australia

Abstract

Introduction:International literature describing the profile of trauma patients attended by a statewide emergency medical services (EMS) system is lacking. Most literature is limited to descriptions of trauma responses for a single emergency medical service, or to patients transported to a specific Level-1 trauma hospital. There is no Victorian or Australian literature describing the type of trauma patients transported by a state emergency medical service.Purpose:The purpose of this study was to define a profile of all trauma incidents attended by statewide EMS.Methods:A retrospective cohort study of all patient care records (PCR) for trauma responses attended by Victorian Ambulance Services for 2002 was conducted. Criteria for trauma categories were defined previously, and data were extracted from the PCRs and entered into a secure data repository for descriptive analysis to determine the trauma profile. Ethics committee approval was obtained.Results:There were 53,039 trauma incidents attended by emergency ambulances during the 12-month period. Of these, 1,566 patients were in physiological distress, 11,086 had a significant pattern of injury, and a further 8,931 had an identifiable mechanism of injury. The profile includes minor trauma (n = 9,342), standing falls (n = 20,511), no patient transported (n = 3,687), and deceased patients (n = 459).Conclusions:This is a unique analysis of prehospital trauma. It provides a baseline dataset that may be utilized in future studies of prehospital trauma care. Additionally, this dataset identifies a ten-fold difference in major trauma between the prehospital and the hospital assessments.

Ambulance demand: random events or predicable patterns?

“…Alcohol related cases were more common on Friday and Saturday nights, especially among young male subjects 20 46 47. Trauma related cases were higher on weekends than weekdays also occurring most frequently among young male subjects 17 21 22. Elderly trauma was more commonly found to occur on Wednesdays and Thursdays 21…”

“…Summer months were associated with increases in the frequency of heroin and alcohol related cases 46 48. Trauma cases occurred most frequently in the summer months in studies in the northern hemisphere,17 22 but trauma cases in the southern hemisphere occurred most frequently during autumn (March, April, May); however, this was limited to a single study 21…”

“…These case type patterns were consistent even though the methods used to assign cases to case types were different across studies and often not well described. For example, trauma cases in the 15–34 year age group were likely to occur over the weekend period while the 75+ age group were more likely to have a traumatic incident requiring ambulance attendance on a Wednesday or Thursday 21. Most case types have similar time of day and day of week temporal patterns across ambulance services and countries.…”

Quantification of opportunities for early-stage paramedicine students to practice clinical skills during clinical placements compared with an equal dose of simulation-based workshops

“…For instance, an audit of CP for second-year and third-year paramedicine students in Victoria, Australia, suggested many students were not receiving adequate case exposure linked to level-appropriate theoretical concepts and learning objectives, resulting in insufficient opportunities to practice clinical skills 12. This mirrors common student complaints about CP that they are often relegated to purely observation roles, unproductive downtime, and are provided only limited opportunities to practice patient care 13 14…”

Do mannequin chests provide an accurate representation of a human chest for simulated decompression of tension pneumothoraxes?

“…[1] In 2002, the Victorian ambulance service attended 1 319 cases that involved either penetrating or blunt injury to the thorax, which accounted for only 2.5% of all trauma cases. [4] The incidence of TPX varies across populations and has not been well established because it is in part due to figures often reporting suspected TPX, rather than an actual diagnosis. [1] The incidence rate of TPX has been reported internationally as between 0.7% to 30% of major trauma patients.…”