TIMING PREOSPEDALIERI E SERVIZI DI EMERGENZA MEDICA: STUDIO PRELIMINARE PRESSO IL TRAUMA SYSTEM EMILIA EST

Introduction: The time factor in prehospital rescue is taken a reference to evaluate the efficiency of the emergency medical services (EMS). The scientific community agrees that the survival of a victim of a major trauma increase following a reduction of the pre-hospital time. The hypothesis of the importance of the prehospital time remains, in terms of trauma, although controversial. The purpose of the study is to determine the prehospital time and related subintervals in the victims of trauma, transported by ambulance in the Trauma System Emilia Est (region Emilia Romagna) and to check whether the injured person arrives at the hospital in a time ≤ 60 minutes and if the on-scene time is ≤ 15 minutes. The two times, taken as a comparison target, represent reference values in the United States, respectively: (1) the golden hour; (2) the ambulance’s average prehospital on-scene time in US. Materials and Methods: Retrospective observational study on all transports that had as a return code 2 or 3, which occurred by ambulance, of patients suffering trauma in the prehospital phase between 2016 and 2018. Results: The 74.6% ( 833/1116 cases) met the inclusion criteria. The average prehospital time an ambulance spent managing trauma was of 56.3 minutes. The average duration of the relevant sub-range was found to be: response time 9.4 minutes; on-scene time 30.1 minutes; transport time 16.4 minutes. In 62.1% (No.517) of cases, hospitalization took place in a time ≤ 60 minutes. In 14.8% (No.123) of the cases, the rescue crew remained at the scene for a time ≤ 15 minutes. Patients were transported in 35.9% (No.299) of cases to a Hub hospital (Trauma Center). Discussion: More than half of the transports, by ambulance, took place while respecting the golden hour. On-scene time is twice as long as the US reality (30.1 minutes instead of 15 minutes). The indications suggested by the authors to reduce prehospital times are: (1) increased training/simulations; (2) increased efficiency of hospital networks; (3) rapid centralization “Hub”; (4) increased data collection/analysis.