Table 1.
Characteristics of injured patients transported by EMS, including EMS provider reasons for selecting hospital destinations.*
| Characteristic | All patients | Patients transported to Level I/II trauma centers | Patients transported to non-trauma hospitals | Seriously injured (ISS ≥ 16) |
|---|---|---|---|---|
| n = 176,981 | n = 74,796 | n = 102,185 | n = 5,752 | |
| Reasons for selecting hospital destinations: | ||||
| Patient/family choice | 89,464 (50.6) | 27,827 (37.2) | 61,636 (60.3) | 1,563 (27.2) |
| Closest facility | 36,660 (20.7) | 13,155 (17.6) | 23,506 (23.0) | 1,013 (17.6) |
| Specialty center | 26,837 (15.2) | 26,446 (35.4) | 392 (0.4) | 2,368 (41.2) |
| Ambulance diversion | 4,240 (2.4) | 1,378 (1.8) | 2,862 (2.8) | 111 (1.9) |
| Physician choice | 3,153 (1.8) | 1,324 (1.8) | 1,830 (1.8) | 202 (3.5) |
| Law enforcement | 857 (0.5) | 330 (0.4) | 528 (0.5) | 36 (0.6) |
| Other | 15,769 (8.9) | 4,337 (5.8) | 11,432 (11.2) | 460 (8.0) |
| Demographics: | ||||
| < 18 years | 22,468 (12.7) | 11,086 (14.8) | 11,382 (11.1) | 622 (10.8) |
| 18 – 54 years | 91,870 (51.9) | 45,208 (60.4) | 46,662 (45.7) | 3,041 (52.9) |
| ≥ 55 years | 62,643 (35.4) | 18,502 (24.7) | 44,141 (43.2) | 2,090 (36.3) |
| Women | 87,276 (49.3) | 30,651 (41.0) | 56,625 (55.4) | 2,067 (35.9) |
| Out-of-hospital physiology, procedures and transport: | ||||
| sBP < 90 mmHg | 4,227 (2.4) | 2,249 (3.0) | 1,979 (1.9) | 420 (7.3) |
| GCS – mean | 14.4 | 14.2 | 14.5 | 12.7 |
| GCS ≤ 8 (%) | 3,576 (2.0) | 2,101 (2.8) | 1,475 (1.4) | 806 (14.0) |
| Intubation attempt | 910 (0.5) | 709 (1.0) | 202 (0.2) | 385 (6.7) |
| Intravenous line placement | 69,223 (39.1) | 38,870 (52.0) | 30,353 (29.7) | 3,638 (63.2) |
| Helicopter transport | 904 (0.5) | 904 (1.2) | 0 (0) | 127 (2.2) |
| Mechanism of injury: | ||||
| Gunshot wound | 1,960 (1.1) | 1,341 (1.8) | 619 (0.6) | 131 (2.3) |
| Stabbing | 2,567 (1.5) | 2,049 (2.7) | 518 (0.5) | 86 (1.5) |
| Assault | 8,950 (5.1) | 4,941 (6.6) | 4,010 (3.9) | 140 (2.4) |
| Fall | 69,031 (39.0) | 21,564 (28.8) | 47,466 (46.5) | 2,088 (36.3) |
| Motor vehicle crash | 59,320 (33.5) | 28,667 (38.3) | 30,653 (30.0) | 2,361 (41.0) |
| Pedestrian or bicycle | 5,954 (3.4) | 3,841 (5.1) | 2,113 (2.1) | 266 (4.6) |
| Other (%) | 29,199 (16.5) | 12,393 (16.6) | 16,807 (16.5) | 681 (11.8) |
| Hospital measures: | ||||
| Level I/II | 74,796 (42.3) | 74,796 (100.0) | 0 (0) | 4,140 (72.0) |
| ISS 0 – 8 | 156,031 (88.2) | 63,149 (84.4) | 92,882 (90.9) | 0 (0) |
| ISS 9 – 15 | 15,197 (8.6) | 7,508 (10.0) | 7,690 (7.5) | 0 (0) |
| ISS >= 16 | 5,752 (3.3) | 4,140 (5.5) | 1,613 (1.6) | 5,752 (100) |
| Major non-orthopedic surgery | 6,963 (3.9) | 4,144 (5.5) | 2,819 (2.8) | 1,450 (25.2) |
| Orthopedic surgery | 33,884 (19.2) | 11,333 (15.2) | 22,551 (22.1) | 1,978 (34.4) |
| In-hospital mortality | 2,773 (1.6) | 1,253 (1.7) | 1,520 (1.5) | 590 (10.3) |
*
ISS = Injury Severity Score; AIS = Abbreviated Injury Scale; sBP = systolic blood pressure; GCS = Glasgow Coma Scale; resource use = in-hospital mortality or major non-orthopedic surgical intervention.
Data are reported as n (%) unless otherwise noted