The potential health impacts of increased mobile phone use for contacting emergency services in life-threatening trauma and emergency events

Abstract

Objectives: To determine whether initial mobile phone reporting of emergencies results in improved survival and hospital resource use in life-threatening trauma situations compared to a landline. Method: A retrospective cohort was constructed by record-linkage and computer algorithm between ambulance and hospital databases in one county 1995–2006 to track individuals from code red calls, through hospital admission to discharge or death. Outcome measures: Mortality—at scene, in ED, and during hospitalisation. Hospital and ICU length of stay (LOS). Analysed using logistic regression by initial exposure (mobile or landline phone) controlling for available potential variables. Results: Emergency mobile phone use increased over the study, plateauing at 22% by 2002. 426,421 ambulance dispatches in the study period; 83% resulted in ambulance attendance. Of those, 32% were dealt with at scene, 2% died at scene, 66% (235,677) were transferred to hospital. Record linkage produced a probability match in 76% to hospital data. 39% (46,563) became inpatients and 1% died in ED. The mean LOS 6.45 days. 7% required ICU (mean LOS 9.39 days). 7% (4464) died in hospital. Mobile phone reporting was associated with a significant reduction in the risk of death at scene compared to landline (OR 0.596, 95% CI: 0.519–0.685). A smaller but significant reduction was observed in hospital transfer from scene (OR 0.932) and subsequent admission (OR 0.811). There was no significant difference between mobile phone and landline use for deaths in ED or hospital. Conclusions: The risks of using a mobile phone when driving are recognised; the potential benefit for reporting emergencies, particularly MVAs and trauma, has not previously been studied. In this retrospective analysis, there is some evidence of an association with mobile use to alert emergency services and lower mortality rates, especially at the scene. Factors including bystander advice and faster ambulance dispatch may explain the observations. Keywords: Mobile phones; Life-threatening events; Pre-hospital; 999 calls