Efficacy of pre-hospital care in trauma patients in Iran

OBJECTIVES: Pre-hospital care plays a vital role in the management of trauma patients. The present study was designed to evaluate the efficacy of the pre-hospital care performed by the Tehran Emergency Medical Service (EMS) in trauma patients. METHODS: The prospective study was performed on trauma patients referred to the emergency department of a teaching hospital by the Tehran EMS from September 2004 until 2005. Considering the lack of scientific observation-based protocols on pre-hospital care, certain protocols were developed based on the available up-to-date protocols in the emergency medicine text books and were used as the gold standard for comparing the provided care by EMSs. RESULTS: The effectiveness of pre-hospital care performed by Tehran emergency technicians, compatible with the patients' condition, was evaluated in 994 patients. Wound bandaging and haemostasis were done correctly in 80% of the indicated cases. Splint was applied correctly in 50% of patients in need for such a device, whereas collar and spinal bed were not performed in 80% of the indicated cases. CONCLUSIONS: Tehran's EMS is not capable of providing trauma patients with effective and accurate pre-hospital care, indicating that major changes are needed to improve this.