The Effects of a Multipatient Trauma Incident on the Probability of Treatment Intervention

Introduction—Multicasualty incidents (MCIs) can be taxing on EMS resources and personnel. In the setting of an MCI, a given patient’s probability of receiving a treatment intervention could differ due to simple time and resource constraints imposed on emergency responders.

Objective—To identify potential differences in treatment interventions between patients involved in a multipatient incident and those involved in a single-patient incident.

Methods—Multivariate logistic regression models were estimated using prehospital trauma data from the North Carolina Prehospital Medical Information System (PREMIS) from July 1, 2012 through December 31, 2012. Inclusionary criteria captured patients with a potential injury, treated and transported by EMS, and at least 18 years of age. The analyses excluded patients who experienced cardiac arrest.

Results—A total of 70,284 patients met the inclusionary criteria. Of these, 5,194 (7.4%) patients were involved in an MCI, while 65,090 (92.6%) patients were involved in a single-patient incident. Patients involved in a multipatient incident were 48% less likely to receive oxygen (OR 0.5178, p=<0.001); 66% less likely to have intravenous access attempted (OR 0.3402, p=<0.001); 51% less likely to receive a 12-lead ECG (OR 0.4899, p=<0.001); 27% less likely to receive spinal immobilization (OR 0.7349, p=<0.001); 76% less likely to receive morphine (OR 0.2408, p=<0.001); and 58% less likely to receive fentanyl (OR 0.4173, Pp=<0.001) compared to patients involved in a single-patient incident.

Conclusion—Analysis found that patients involved in an MCI were less likely to receive many treatment interventions (such as oxygen, spinal immobilization, IV attempt, fentanyl, morphine and 12-lead ECG).