Efficacy and outcomes of a highland prehospital trauma response team

Abstract

Background and aims: The Scottish Highlands face unique prehospital care challenges due to population dispersity, mountainous terrain, seasonal weather, and higher trauma burden compared to the nearest Major Trauma Centres (MTCs) as highlighted by the Scottish Trauma Audit Group (STAG). Primary road/air transfer from scene to nearest designated MTC averages 1–5 hours, making prompt and informed utilisation of prehospital and in-hospital resources within the Highlands critical – comparative to other UK metropolitan regions where the trauma population majority lay within 20–45 minute transfer windows. This paper reviews the Highland pre-hospital immediate care and trauma (PICT) Team's trauma response through a retrospective review of PICT patient report forms (PRFs). Methods and results: The analysis highlighted increased trauma response by the team in the nature of attended callouts and interventions utilised. Improving trends of patient outcomes, increased advanced analgesia and medico-surgical intervention utilisation, and relative increase of road traffic collision attendance and trauma-specific calls were noted Conclusion: Results highlight the Scottish Highlands’ trauma burden and PICT's added value; with increased trauma response and improving outcomes. Despite the rate and ratio of major trauma not reducing PICT Team utilisation has, potentially led to fewer patients over narrower geography at later stages in emergency calls accessing the enhanced care doctor and advanced physician team than was achieved previously.