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Study Highlights Massachusetts' Need for Better Emergency Treatment for Highway Accident Victims

March 01, 2007

BOSTON --- A new study by Health and Safety Research Inc. highlights the need for greater use of emergency transport and trauma center care to treat life-threatening injuries suffered on Massachusetts' highways. The research findings are particularly striking because for the study year Massachusetts had the lowest crash death rate in the U.S., and one of the 10 lowest in the world. This suggests that other states and countries may under-utilize life-saving resources at higher rates than shown in this study. The HSRI comprehensive one-year statewide study of the response of Massachusetts' EMS and hospital system to people involved in fatal-level car crashes appears in the February 2007 Journal of Trauma, a leading peer-reviewed medical journal. The study was conducted under the auspices of the Massachusetts Department of Public Health and the Massachusetts Governor's Highway Safety Bureau. A sophisticated methodology tracked the path and outcome of every involved person, whether transported or not, starting at the crash scene. This included helicopter and ground ambulance use, community or specialized trauma center hospital treatment, and inter-hospital transfers. Qualification for helicopter transport and trauma center care was calculated using state and national guidelines. The study considered age, sex, pre-existing conditions, complications, overall injury severity, geographic location and distances from the crash scene to treatment locations. Among other major findings, the HSRI study shows that 83% of people who qualified for direct helicopter transport to a trauma center did not receive it. Sixty-two percent of people who qualified for direct transport (by helicopter or ground) to a trauma center did not receive it. Helicopters did not arrive at 88% of the crashes, primarily because they were never requested. Survival varied by a factor of 3 between the state's five EMS regions, and up to a factor of 10 times, depending where and how people were taken for treatment. The people who qualified and received transport directly to a trauma center overall had about twice the survival of those who qualified but did not receive those resources. "Advanced transport and hospital resources can't be effective when victims are not directed to them," said Nicholas Mango, lead author of the study. "Our findings show that the majority of severely injured persons did not receive the advanced medical resources they qualified for. Had they received those services, we believe crash fatalities could be substantially reduced."
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