Objectives: To assess the effect of a mobile phone application for prehospital notification on resuscitation and patient outcomes.
Design: Longitudinal prospective cohort study with preintervention and postintervention cohorts.
Setting: Major trauma centre in India.
Participants: Injured patients being transported by ambulance and allocated to red (highest) and yellow (medium) triage categories.
Intervention: A prehospital notification application for use by ambulance and emergency clinicians to notify emergency departments (EDs) of an impending arrival of a patient requiring advanced lifesaving care.
Main Outcome Measures: The primary outcome was the proportion of eligible patients arriving at the hospital for which prehospital notification occurred. Secondary outcomes were the availability of a trauma cubicle, presence of a trauma team on patient arrival, time to first chest X-ray, and ED and in-hospital mortality.
Results: Data from January 2017 to January 2018 were collected with 208 patients in the preintervention and 263 patients in the postintervention period. The proportion of patients arriving after prehospital notification improved from 0% to 11% (p<0.001). After the intervention, more patients were managed with a trauma call-out (relative risk (RR) 1.30; 95% CI: 1.10 to 1.52); a trauma bay was ready for more patients (RR 1.47; 95% CI: 1.05 to 2.05) and a trauma team leader present for more patients (RR 1.50; 95% CI: 1.07 to 2.10). There was no difference in time to the initial chest X-ray (p=0.45). There was no association with mortality at hospital discharge (RR 0.94; 95% CI: 0.72 to 1.23), but the intervention was associated with significantly less risk of patients dying in the ED (RR 0.11; 95% CI: 0.03 to 0.39).
Conclusions: The prehospital notification application for severely injured patients had limited uptake but implementation was associated with improved trauma reception and reduction in early deaths. Quality improvement efforts with ongoing data collection using the trauma registry are indicated to drive improvements in trauma outcomes in India.
Trial Registration Number: NCT02877342.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7311027 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2019-033236 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A Pilot Rapid Triage Process for Prehospital ST-Segment Myocardial Infarction Patients Direct to the Catheterization Lab.
Cureus
November 2024
Department of Cardiology, Johns Hopkins University School of Medicine, Baltimore, USA.
Background Rapid treatment of ST-elevation myocardial infarction (STEMI) patients with primary percutaneous coronary intervention (PCI) significantly reduces morbidity and mortality rates. Recent studies emphasize the importance of reducing total ischemic time, making first-medical-contact-to-balloon (FMCTB) time a key performance indicator. To improve FMCTB times in patients brought to the Emergency Department (ED) by Emergency Medical Services (EMS), we implemented a "Direct to Lab" (DTL) workflow during the following conditions: weekday daytime hours, when the lab is fully staffed, and for hemodynamically stable STEMI patients presenting via EMS.
View Article and Find Full Text PDFPre-alerts from critical care ambulances to trauma centers: a quantitative survey of trauma team leaders in Ontario, Canada.
Scand J Trauma Resusc Emerg Med
December 2024
Ornge, Mississauga, ON, Canada.
Introduction: Pre-alerts from paramedics to trauma centers are important for ensuring the highest quality of trauma care. Despite this, there is a paucity of data to support best practices in trauma pre-alert notifications. Within the trauma system of Ontario, Canada, the provincial critical care transport organization, Ornge, provides pre-alerts to major trauma centers, but standardization is currently lacking.
View Article and Find Full Text PDFTraffic Patterns and Emergency Medical Services Prenotification Transport Estimates in Trauma Activations.
Open Access Emerg Med
November 2024
Department of Emergency Medicine, Northwell Health, Long Island, NY, USA.
Objective: To determine whether traffic patterns affect the accuracy of emergency medical services (EMS) prediction of transport interval to the emergency department (ED).
Methods: Using a retrospective study, we examined all trauma activations at a level one, urban trauma center in Manhasset, New York, between 5/22/2021 and 3/30/2022. Inclusion criteria included patients ≥18 years and arrival by EMS.
Barriers to Effective Prehospital and Hyperacute Stroke Care in India: A Physician Perspective.
J Emerg Trauma Shock
August 2024
The World Stroke Organization Taskforce for Prehospital Care, Geneva, Switzerland.
Introduction: The incidence of stroke is increasing in India. Prehospital stroke care is crucial for reducing stroke morbidity and mortality, but its implementation in India faces several challenges. Limited original research exists on prehospital stroke care in India, making it essential to identify the problems in implementing effective prehospital stroke care.
View Article and Find Full Text PDFSaving Time Saves Lives: Optimizing Radio Dispatching in Out-of-Hospital Cardiac Arrests.
Cureus
September 2024
Population and Community Health, University of North Texas Health Science Center, Fort Worth, USA.
Objective Activation of emergency medical services (EMS) through radio dispatching in the United States of America is the established first component in the link of the Chain of Survival. However, little is known about how auditory dispatch alerts operationally aid in the recognition and physical response of priority dispatch communications. This research aims to determine if a modification in radio alerting procedures will elicit a reduction in chute times for first responders.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!