The association of crash response times and deaths at the crash scene: A cross-sectional analysis using the 2019 National Emergency Medical Service Information System.

Abstract

Deaths at the crash scene (DAS) are crash deaths that occur within minutes after a crash. Rapid crash responses may reduce the occurrence of DAS. This study aims to assess the association of crash response time and DAS during the rush and nonrush hour periods by rurality/urbanicity. This single-year cross-sectional study used the 2019 National Emergency Medical Services (EMS) Information System. The outcome variable was DAS. The predictor variables were crash response measures: EMS Chute Initiation Time (ECIT) and EMS Travel Time (ETT). Age, gender, substance use, region of the body injured, and the revised trauma score were used as potential confounders. Logistic regression was used to assess the unadjusted and adjusted odds of DAS. A total of 654,675 persons were involved in EMS-activated road crash events, with 49.6% of the population exposed to crash events during the rush hour period. A total of 2,051 persons died at the crash scene. Compared to the baseline of less than 1minute, ECIT ranging from 1 to 5minutes was significantly associated with 58% (95% CI: 1.45-1.73) increased odds of DAS. Also, when compared to the baseline of less than 9minutes, ETT ranging between 9 and 18minutes was associated with 34% (95% CI: 1.22-1.47) increased odds of DAS. These patterns were consistent during the rush and nonrush hour periods and across rural and urban regions. Reducing crash response times may reduce the occurrence of DAS.