Twenty Minutes of Transport Time as a Threshold for Minimizing Scene Time in Firearm Injury

BackgroundPrevious studies have emphasized the value of minimizing scene time for improving outcomes after firearm injury. We investigated if the relationship between scene time and survival varied by transport time.MethodsA retrospective study was conducted on patients treated as full trauma activations for firearm injuries at a single level one trauma center from 2010 to 2023. Subgroup analyses were conducted by categorizing according to transport time: <5 min, 5-9 min, 10-14 min, 15-19 min, 20-24 min, 25-29 min, 30-39 min, 40-49 min, and ≥60 min. Logistic regression was used to measure the impact of scene time on survival in each of these subgroups.ResultsA total of 1653 patients with firearm injuries were documented in the trauma database, including prehospital time, from 2010 to 2023. Logistic regression indicated that reduced scene time was associated with increased survival in patients with transport durations under 20 min. Adjusted analyses were performed and found an OR of 0.93 (CI [0.91-0.95]) between scene time and survival in patients with short transport times and OR of 1.00 (CI [0.95-1.06]) in patients with long transport times.ConclusionIn this single institution study of firearm injury, decreased scene time was associated with increased survival only for patients with a transport time of less than 20 min. At transport times of 20 min or greater, minimizing scene time did not increase survival.