Comparison between two mobile pre-hospital care services for trauma patients

Ricardo Gonsaga,Gustavo Fraga,Izabela Brugugnolli

doi:10.1186/1749-7922-7-s1-s6

Ricardo Gonsaga, Gustavo Fraga + Show 1 more

Open Access

https://doi.org/10.1186/1749-7922-7-s1-s6

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Abstract

ObjectivesPre-hospital care (PH) in Brazil is currently in the phase of implementation and expansion, and there are few studies on the impacts of this public health service. The purpose of this study is to assess the quality of care and severity of trauma among the population served, using trauma scores, attendance response times, and mortality rates. This work compares two pre-hospital systems: the Mobile Emergency Care Service, or SAMU 192, and the Fire Brigade Group, or CB.MethodDescriptive study evaluating all patients transported by both systems in Catanduva, SP, admitted to a single hospital.Results850 patients were included, most of whom were men (67.5%); the mean age was 38.5 ± 18.5 years. Regarding the use of PH systems, most patients were transported by SAMU (62.1%). The trauma mechanisms involved motorcycle accidents in 32.7% of cases, transferred predominantly by SAMU, followed by falls (25.8%). Regarding the response time, CB showed the lowest rates. In relation to patient outcome, only 15.5% required hospitalization. The average score on the Glasgow Coma Scale was 14.7 ± 1.3; average RTS was 7.7 ± 0.7; ISS 3.8 ± 5.9; and average TRISS 97.6 ± 9.3. The data analysis showed no statistical differences in mortality between the groups studied (SAMU - 1.5%; CB - 2.5%). The trauma scores showed a higher severity of trauma among the fatal victims.ConclusionTrauma victims are predominantly young and male; the trauma mechanism that accounted for the majority of PH cases was motorcycle accidents; CB responded more quickly than SAMU; and there was no statistical difference between the services of SAMU and CB in terms of severity of the trauma and mortality rates.

Highlights

Trauma injuries are becoming an increasing public health issue, especially in developing countries, whether due to their high mortality rates, or due to the high financial costs of treatment and recovery of these patients.Reicheneim et al [1,2] classify violence in Brazil as the sixth highest cause of hospitalization, and the third highest cause of mortality
Regarding the use of Pre-hospital care (PH) systems, most patients were transported by SAMU (62.1%)
The trauma mechanisms involved motorcycle accidents in 32.7% of cases, transferred predominantly by SAMU, followed by falls (25.8%)

Summary

Introduction

Reicheneim et al [1,2] classify violence in Brazil as the sixth highest cause of hospitalization, and the third highest cause of mortality. The American system favors care carried out by paramedics (technicians), while the French favors the presence of doctors at the scene of the incident. Such systems usually have good results in terms of reducing morbidity and mortality, and neither model has been shown to be more effective than the other [3,4,5,6,7].

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