The Effect of All-Terrain Vehicle Crash Location on Emergency Medical Services Time Intervals

Brandon M Wubben,Charles A Jennissen,Gerene M Denning

doi:10.3390/safety5040073

Abstract

Over 100,000 all-terrain vehicle (ATV)-related injuries are evaluated in U.S. emergency departments each year. In this study, we analyzed the time intervals for emergency medical services (EMS) providers responding to ATV crashes in different location types. Data from the Iowa State Trauma Registry and a statewide ATV crash/injury database was matched with Iowa EMS Registry records from 2004–2014. Ground ambulance responses to 270 ATV crashes were identified, and response characteristics and time intervals were analyzed. Off-road crashes had a longer median patient access interval (p < 0.001) and total on scene interval (p = 0.002) than roadway crashes. Crashes in remote locations had a longer median patient access interval (p < 0.001) and total on scene interval (p < 0.001), but also a longer median on scene with patient interval (p = 0.004) than crashes in accessible locations. Fifteen percent of remote patient access times were >6 min as compared to 3% of accessible crashes (p = 0.0004). There were no differences in en route to scene or en route to hospital time. Comparisons by location type showed no differences in injury severity score or number of total procedures performed. We concluded that responding EMS providers had an increased length of time to get to the patient after arriving on scene for off-road and remote ATV crashes relative to roadway and accessible location crashes, respectively.

Highlights

All-terrain vehicle (ATV) crashes in the U.S have accounted for over 11,000 fatalities over the past 20 years and about 100,000 emergency department (ED) visits annually, with over one-fifth of the fatalities involving children under 16 years of age [1]
Emergency medical services (EMS) providers have indicated that responding to off-road and remote ATV crashes, including those in dedicated off-highway vehicle (OHV) parks, is often more time consuming than other locations
The current study demonstrated a similar percentage of roadway crashes (39%), but did not demonstrate any differences in Injury Severity Score (ISS) between crash locations, there were more abnormal GCS scores in those who crashed on roadways

Summary

Introduction

All-terrain vehicle (ATV) crashes in the U.S have accounted for over 11,000 fatalities over the past 20 years and about 100,000 emergency department (ED) visits annually, with over one-fifth of the fatalities involving children under 16 years of age [1]. Emergency medical services (EMS) providers have indicated that responding to off-road and remote ATV crashes, including those in dedicated off-highway vehicle (OHV) parks, is often more time consuming than other locations. Some parks have posted warnings that crash patients will be difficult to locate and access due to poor cell phone service and geographical barriers [4]. A Nevada State Recreational Area suggested that a sign be posted stating that “emergency responses can be delayed up to three hours. EMS responses to both medical and traumatic incidents on public trails and in wilderness areas have been noted to be uniquely challenging [6]

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