Prehospital Physician Presence Is Associated with Decreased Mortality for Trauma Patients

Most prehospital trauma care is provided by paramedics in the U.S., while prehospital emergency medical services (EMS) physicians are the norm in much of Europe. These authors conducted a systematic review to compare mortality for trauma patients who received care from either paramedic-led or physician-led prehospital teams. For a study to be included, injury severity had to be comparable between the two groups.

Twenty-two studies with approximately 55,000 severely injured patients were included; nearly all studies were retrospective and observational. Mortality was lower when prehospital physicians were present (odds ratio, 0.81). Results changed only minimally when the analysis was limited to studies published after 2005 (OR, 0.75) or to t…