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    Motor Vehicle Crash Characteristics That Are Predictive of High Acuity Patients: An Analysis of Linked Ambulance and Crash Data

    80398.pdf (372.1Kb)
    Access Status
    Open access
    Authors
    Ceklic, Ellen
    Tohira, Hideo
    Ball, Stephen
    Brown, Elizabeth
    Brink, D.
    Bailey, Paul
    Whiteside, Austin
    Finn, Judith
    Date
    2020
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Ceklic, E. and Tohira, H. and Ball, S. and Brown, E. and Brink, D. and Bailey, P. and Whiteside, A. et al. 2020. Motor Vehicle Crash Characteristics That Are Predictive of High Acuity Patients: An Analysis of Linked Ambulance and Crash Data. Prehospital Emergency Care. 25(3): pp.351-360.
    Source Title
    Prehospital Emergency Care
    DOI
    10.1080/10903127.2020.1771487
    ISSN
    1090-3127
    Faculty
    Faculty of Health Sciences
    School
    School of Nursing, Midwifery and Paramedicine
    Funding and Sponsorship
    http://purl.org/au-research/grants/nhmrc/1116453
    Remarks

    This is an accepted manuscript of an article published by Taylor & Francis in Prehospital Emergency Care on 10/06/2020 available online at http://www.tandfonline.com/10.1080/10903127.2020.1771487.

    URI
    http://hdl.handle.net/20.500.11937/80336
    Collection
    • Curtin Research Publications
    Abstract

    © 2020 National Association of EMS Physicians. Background: Motor vehicle crashes (MVCs) comprise a significant component of emergency medical service workload. Due to the potential for life-threatening injuries, ambulances are often dispatched at the highest priority to MVCs. However, previous research has shown that only a small proportion of high-priority ambulance responses to MVCs encounter high acuity patients. Alternative methods for triaging patients over the phone are required to reduce the burden of over-triage. One method is to use information readily available at the scene (e.g. whether a person was a motorcyclist, ejection status or whether an airbag deployed) as potential predictors of high acuity. Methods: A retrospective cohort study was conducted of all MVC patients in Perth attended by St John Western Australia between 2014 and 2016. Ambulance data was linked with Police crash data. The outcome variable of interest was patient acuity, where high acuity was defined as where a patient (1) died on-scene or (2) was transported by ambulance on priority one (lights & sirens) from the scene to hospital. Crash characteristics that are predictive of high acuity patients were identified by estimating crude odds ratios and 95% confidence intervals. Results: Of the 18,917 MVC patients attended by SJ-WA paramedics, 6.4% were classified as high acuity patients. The odds of being a high acuity patient was greater for vulnerable road users (motorcyclists, pedestrians and cyclists) than for motor vehicle occupants (OR 3.19, 95% CI, 2.80–3.64). A ‘not ambulant patient’ (one identified by paramedics as unable to walk or having an injury incompatible with being able to walk) had 15 times the odds of being high acuity than ambulant patients (OR 15.34, 95% CI, 11.48–20.49). Those who were trapped in a vehicle compared to those not trapped (OR 4.68, 95% CI, 3.95–5.54); and those who were ejected (both partial and full) from the vehicle compared to those not ejected (OR 6.49, 95% CI, 4.62–9.12) had higher odds of being high acuity patients. Discussion: There were two important findings from this study: (1) few MVC patients were deemed to be high acuity; and (2) several crash scene characteristics were strong predictors of high acuity patients.

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