Prehospital care: Lessons learned from 311 mortalities at level I trauma center

Area of Science:

• Trauma care research
• Public health interventions
• Emergency medicine systems

Background:

• Trauma is a leading global cause of death and disability.
• Low-middle-income countries face challenges with emergency medical systems (EMS).
• Timely intervention, especially within the
• golden hour
• , is critical for trauma survival.

Purpose of the Study:

• To retrospectively analyze trauma mortalities at a Level 1 trauma center in India.
• To compare outcomes of trauma patients who received prehospital care versus those who did not.
• To identify factors influencing trauma mortality in a resource-limited setting.

Main Methods:

• Retrospective observational study of trauma deaths from April 2019 to April 2020.
• Included patients who died during hospitalization; excluded those deceased on arrival, receiving CPR, or non-trauma deaths.
• Analyzed demographics, clinical data, transport methods, and causes of death using SPSS 14 (p < 0.05).

Main Results:

• 311 mortalities among 55,277 trauma patients; predominantly young males with blunt trauma (road traffic injuries, falls).
• Common presentations included airway compromise, tachycardia, and hypotension; traumatic brain injury was prevalent.
• Prehospital care, though associated with delayed arrival, correlated with higher oxygen saturation and systolic blood pressure.

Conclusions:

• Strengthening prehospital care and EMS infrastructure is essential in low-resource settings.
• Prehospital care positively influenced physiological parameters, suggesting potential for improved outcomes.
• Developing comprehensive EMS is imperative for effective trauma mortality reduction globally.