Nature and Outcome of Prehospital Care in an Informal Trauma System

Abstract

Objective: Our aim was to describe the features of prehospital
management in our region with no formal trauma system, and
measure its effectiveness using survival and complication as
outcome parameters.
Patients and Methods: This is a prospective analysis of
prehospital management of the injured in an informal trauma
system using 180 consecutive patients seen in a tertiary trauma
care centre.
Results: The mean injury severity score (ISS) was 13. The mean
prehospital time was 16.46 hours. Prehospital care (PHC) was
carried out in 15 of 180 patients (8.3%), and in 14 of these by the
populace. The relative risk of complication when no prehospital
care was given was 2.64. There was a statistically significant
relationship between PHC vis-a-vis survival and complication (p <
0.05). A similar effect was not observed with delay in presentation.
Conclusions: Prolonged prehospital time (> 16 hrs) is
indicative of non-existence of a formal trauma care system. PHC is
of greater relevance, than speed of presentation, to outcome in this
population of patients with less than major trauma.