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Titre du document / Document title

Emergency Medical Service (EMS) systems in developed and developing countries

Auteur(s) / Author(s)

ROUDSARI Bahman S. (1) ; NATHENS Avery B. (2) ; ARREOLA-RISA Carlos (3) ; CAMERON Peter (4) ; CIVIL Ian (5) ; GRIGORIOU Giouli (6) ; GRUEN Russel L. (7) ; KOEPSELL Thomas D. (8 9) ; LECKY Fiona E. (10) ; LEFERING Rolf L. (11) ; LIBERMAN Moishe (12) ; MOCK Charles N. (8 13) ; OESTERN Hans-Jörg (14) ; PETRIDOU Elenie (15 16) ; SCHILDHAUER Thomas A. (17) ; WAYDHAS Christian (18) ; ZARGAR Moosa (19) ; RIVARA Frederick P. (8 20) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Epidemiology, University of Texas, School of Public Health, ETATS-UNIS
(2) St. Michael's Hospital, Toronto, CANADA
(3) Secretaría de Salud, Sistema Estatal de Atención de Emergencias Médicas, Monterrey, Nuevo León, MEXIQUE
(4) Department Epidemiology and Preventive Medicine, Monash School of Public Health, Alfred Hospital, AUSTRALIE
(5) University of Auckland, Auckland Hospital, Auckland, NOUVELLE-ZELANDE
(6) Center for Research and Prevention of Injuries, Medical School, University of Athens, Athens, GRECE
(7) Department of Health Services Research and Policy, Menzies School of Health Research, AUSTRALIE
(8) Harborview Injury Prevention and Research Center, Department of Epidemiology, University of Washington, Seattle, ETATS-UNIS
(9) Harborview Injury Prevention and Research Center, Department of Health Services, University of Washington, Seattle, ETATS-UNIS
(10) University of Manchester, Department of Emergency Medicine, Manchester, ROYAUME-UNI
(11) Biochemical & Experimental Division, University of Cologne, Cologne, ALLEMAGNE
(12) Montreal General Hospital, McGill University Health Center, Divisions of Surgery and Clinical Epidemiology, Montreal, CANADA
(13) Harborview Injury Prevention and Research Center, Department of Surgery, University of Washington, Seattle, ETATS-UNIS
(14) Chefarzt der Klinik für, Unfall und Wiederherstellungschirurgie, Allgemeines Krankenhaus Celle, ALLEMAGNE
(15) Department of Hygiene and Epidemiology, Athens University Medical School, Athens, GRECE
(16) Department of Epidemiology, Harvard School of Public Health, Boston, MA, ETATS-UNIS
(17) Chirurgische Klinik und Poliklinik, BG Kliniken Bergmannsheil, Ruhr-Universitat Bochum, Bochum, ALLEMAGNE
(18) Klinik und Poliklinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstr, ALLEMAGNE
(19) Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IRAN, REPUBLIQUE ISLAMIQUE D'
(20) Harborview Injury Prevention and Research Center, Department of Pediatrics, University of Washington, Seattle, ETATS-UNIS

Résumé / Abstract

Objectives: To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. Method: We collated de-identified patient-level data from national or local trauma registries in Australia, Austria, Canada, Greece, Germany, Iran, Mexico, New Zealand, the Netherlands, the United Kingdom and the United States. Patient and injury-related characteristics of trauma victims with injury severity score (ISS) >15 and the pre-hospital trauma care provided to these patients were compared among different countries. Results: A total of 30,339 subjects from one or several regions in 11 countries were included in this analysis. Austria (51%), Germany (41%) and Australia (30%) reported the highest proportion of air ambulance use. Monterrey, Mexico (median 10.1 min) and Montreal, Canada (median 16.1 min) reported the shortest and Germany (median: 30 min) and Austria (median: 26 min) reported the longest scene time. Use of intravenous fluid therapy among advanced EMS systems without physicians as pre-hospital care providers, varied from 30% (in the Netherlands) to 55% (in the US). The corresponding percentages in advanced EMS systems with physicians actively involved in pre-hospital trauma care, excluding Montreal in Canada, ranged from 63% (in London, in the UK) to 75% in Germany and Austria. Austria and Germany also reported the highest percentage of pre-hospital intubation (61% and 56%, respectively). Conclusion: This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients.

Revue / Journal Title

Injury    ISSN  0020-1383   CODEN INJUBF 

Source / Source

2007, vol. 38, no9, pp. 1001-1013 [13 page(s) (article)] (44 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, Kidlington, ROYAUME-UNI  (1969) (Revue)

Mots-clés anglais / English Keywords

Performance evaluation

;

Intubation

;

Trachea

;

Treatment

;

Intravenous administration

;

Care

;

Trauma

;

Human

;

Hospital

;

Developing countries

;

Emergency

;

Mots-clés français / French Keywords

Evaluation performance

;

Intubation

;

Trachée

;

Traitement

;

Voie intraveineuse

;

Soin

;

Traumatisme

;

Homme

;

Hôpital

;

Pays en développement

;

Urgence

;

Mots-clés espagnols / Spanish Keywords

Evaluación prestación

;

Intubación

;

Tráquea

;

Tratamiento

;

Vía intravenosa

;

Cuidado

;

Traumatismo

;

Hombre

;

Hospital

;

Países en desarrollo

;

Urgencia

;

Mots-clés d'auteur / Author Keywords

Pre-hospital trauma care

;

Emergency Medical Service (EMS) systems

;

Developed and developing countries

;

Advanced Life Support

;

Basic Life Support

;

Intravenous fluid therapy

;

Endotracheal intubation

;

Localisation / Location

INIST-CNRS, Cote INIST : 15593, 35400016243066.0030

Nº notice refdoc (ud4) : 19050152



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