Private Vehicle Transport vs. Emergency Medical Services Transport for Penetrating Trauma

Because we will never be able to conduct a randomized trial, benefits of emergency medical services (EMS) have always been, and probably always will be, controversial. These authors compared outcomes for adult (age >16 years) patients with penetrating trauma who were transported by private vehicle or ground EMS. Their multivariable model adjusted for vital signs, Glasgow Coma Scale motor score, injury severity score, demographics, insurance type, and year of admission.

Among more than 100,000 eligible participants, patients transported by private vehicle had significantly lower in-hospital mortality than patients transported by EMS (odds ratio, 0.38). These results were consistent across multiple subgroups and sensitivity analyses.