Retrospective Analysis of Trauma Transfers - RATTS
Aim
The overall aim of the proposed research is to identify factors associated with the adherence to the Ambulance Service of NSW (ASNSW) Protocol 4 (the trauma bypass protocol). Specifically, the objectives are:
- to identify the rates of compliance along with the predictors of non compliance to Protocol 4 in the Sydney metropolitan area
- to estimate the time-to-definitive care in rural NSW and
- to determine whether interventions implemented by the NSW Ambulance Service have had any effect on adherence to Protocol 4
Methods
All patients who meet the requirement for Protocol 4 will be identified from the Computer-Aided Dispatch database. A review of all cases since January 2000 will be performed, and rates of compliance with Protocol 4 will be examined. Trends in compliance rates over the period will be analysed to assess changes over time.
Predictors of non-compliance to Protocol 4 will be modeled for the entire dataset. Variables examined will include: patient age, gender, postcode (for place of residence and site of injury), the mechanism of injury, Glasgow Coma Scale (GCS) scores, heart rate, diastolic and systolic blood pressure and respiratory rates, level of training of the ambulance officer and the time taken to transport the patient.
A subset analysis of the above will be undertaken for rural trauma patients. Specifically, time-to-definitive care will be modeled to investigate key determinants that are associated with the time-to-definitive care. Time of call vs time of incident, as well as whether call for assistance was made from scene or from another site such as the initial receiving hospital will also be examined.
Finally, to assess whether interventions specifically designed to increase adherence to Protocol 4 have actually had an effect on compliance rates, we will model the same data using an interrupted time series approach.
Results/Status
Data collection for this study is underway.
Institute Investigators
- Mark Stevenson
- Colman Taylor