Student Presenter(s): Mohammad Aktar, Maria Aliberti, Benjamin Winchel, Sourish Rathi
Faculty Mentor: Stephen M. DiRusso
Department: Clinical Sciences
School/College: College of Osteopathic Medicine, Long Island

Introduction: Quality of pre-hospital care, time to onset of definitive care and on-scene care can impact patient outcomes.

Objective: Evaluate the relationship between hospital dispositions at a Level II Trauma center (discharged, increased care and treatment, or death) and EMS response times (time to scene, total time at scene, total time of call).

Methods: Trauma Registry data from 3068 patients admitted to St. Barnabas Hospital were analyzed. Patients were grouped based on discharge disposition: Against Medical Advice (AMA) or Discharged Home, Discharged to Alternate level of care, Died. Time variables were: time in transit to the hospital, time at the scene, and the total time of the call. Groups were compared using the Kruskal Wallis test in SPSS.

Results: Regarding Hospital Disposition, 1923 (62.7%) patients were discharged as AMA/went home, 1057 (34.5%) patients needed further medical treatment, and 88 (2.9%) patients died in the hospital. Patients who were disposed to further medical treatment had longer time spent at the scene (21 mins) compared to patients who went home (16 mins) or died in hospital (15.5 mins) (p<0.001).

Conclusion: Patients who died in the hospital had shorter transit times, perhaps because EMS anticipated additional on-scene treatment was unnecessary or foresaw better patient outcomes in the hospital. EMS spent more time in the field with patients that had indications for in-field treatment, which could have contributed to better patient outcomes.