Prehospital Care Times and Interventions for Victims of Major Trauma in the Central Region of Portugal: A Retrospective Study

Authors

  • Sandra Rito *Co-primeira autora. Serviço de Medicina Intensiva. Unidade Local de Saúde de Coimbra. Coimbra; Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA:E). Escola Superior de Enfermagem de Coimbra. Coimbra. https://orcid.org/0009-0003-7903-3517
  • Ricardo J.O. Ferreira *Co-primeiro autor. Serviço de Medicina Intensiva. Unidade Local de Saúde de Coimbra. Coimbra; Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA:E). Escola Superior de Enfermagem de Coimbra. Coimbra; Centro de Investigação, Inovação e Desenvolvimento em Enfermagem de Lisboa (CIDNUR). Escola de Enfermagem de Lisboa. Lisboa; Instituto de Saúde Ambiental (ISAMB). Faculdade de Medicina. Universidade de Lisboa. Lisboa. https://orcid.org/0000-0002-2517-0247
  • Nuno Marques Delegação Regional do Centro. Instituto Nacional de Emergência Médica. Coimbra; Centro de Formação de Coimbra. Instituto Nacional de Emergência Médica. Coimbra. https://orcid.org/0000-0002-8842-4347
  • Alexandre Frutuoso Delegação Regional do Centro. Instituto Nacional de Emergência Médica. Coimbra; Centro de Formação de Coimbra. Instituto Nacional de Emergência Médica. Coimbra. https://orcid.org/0000-0003-0375-4740
  • Rui Baptista Unidade de Investigação em Ciências da Saúde: Enfermagem (UICISA:E). Escola Superior de Enfermagem de Coimbra. Coimbra; Escola Superior de Enfermagem de Coimbra. Coimbra. https://orcid.org/0000-0002-4125-1186

DOI:

https://doi.org/10.20344/amp.20983

Keywords:

Advanced Trauma Life Support Care, Emergency Medical Services, Emergency Medicine, Time Factors, Transportation of Patients, Wounds and Injuries

Abstract

Introduction: The quality and promptness of prehospital care for major trauma patients are vital in order to lower their high mortality rate. However, the effectiveness of this response in Portugal is unknown. The objective of this study was to analyze response times and interventions for major trauma patients in the central region of Portugal.
Methods: This was a retrospective, descriptive study, using the 2022 clinical records of the National Institute of Medical Emergency’s differentiated resources. Cases of death prior to arrival at the hospital and other non-transport situations were excluded. Five-time intervals were determined, among which are the response time (T1, between activation and arrival at the scene), on-scene time (T2), and transportation time (T5; between the decision to transport and arrival at the emergency service). For each ambulance type, averages and dispersion times were calculated, as well as the proportion of cases in which the nationally and internationally recommended times were met. The frequency of recording six key interventions was also assessed.
Results: Of the 3366 records, 602 were eliminated (384 due to death), resulting in 2764 cases: nurse-technician ambulance (SIV) = 36.0%, physician- nurse ambulance (VMER) = 62.2% and physician-nurse helicopter = 1.8%. In a very large number of records, it was not possible to determine prehospital care times: for example, transport time (T5) could be determined in only 29%, 13% and 8% of cases, respectively for SIV, VMER and helicopter. The recommended time for stabilization (T2 ≤ 20 min) was met in 19.8% (SIV), 36.5% (VMER) and 18.2% (helicopter). Time to hospital (T5 ≤ 45 min) was achieved in 80.0% (SIV), 93.1% (VMER) and 75.0% (helicopter) of the records. The administration of analgesia (42% in SIV) and measures to prevent hypothermia (23.5% in SIV) were the most recorded interventions.
Conclusion: There was substantial missing data on statuses and a lack of information in the records, especially in the VMER and helicopter. According to the records, the time taken to stabilize the victim on-scene often exceeded the recommendations, while the time taken to transport them to the hospital tended to be within the recommendations.

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Published

2024-07-01

How to Cite

1.
Rito S, Ferreira RJ, Marques N, Frutuoso A, Baptista R. Prehospital Care Times and Interventions for Victims of Major Trauma in the Central Region of Portugal: A Retrospective Study. Acta Med Port [Internet]. 2024 Jul. 1 [cited 2024 Jul. 25];37(7-8):526-34. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/20983