SHBC1111

D.G.LIM¹, L.Q.CHIU¹, M.Y.L.LIM¹, C.Y.T.HEAH¹, B.GLORIA¹, W.Q.HENG¹, C.LOH¹ 

Tan Tock Seng Hospital¹

The Singapore Civil Defence Force (SCDF) issues pre-hospital notification to EDs if trauma patients meet a set of prehospital criteria.  This allows prioritization (and potential diversion) of resources for such patients.  Hence a reasonable criterion is necessary to achieve a balance between expediting and optimizing care for sick patients and resource wastage. This study aims to determine the demographics and outcomes of these cases.

A retrospective analysis of pre-hospital trauma standbys from 1 Oct 2020 to 31 Mar 2021 was performed. The pre-hospital trauma standby criteria were obtained from the SCDF.

234 pre-hospital trauma standbys were received. 79% were male and 55.6% presented during the day (7am to 7pm). The majority sustained blunt trauma (94.4%).  Patient outcomes were as follows: 4 (1.7%) discharged, 145 (62%) to general ward, 51 (21.8%) to high dependency/intensive care unit, 18 (7.7%) direct to operating room/angioembolization and 16 (6.8%) deaths. 

Overall, 173 (73.9%) required inpatient subspecialty review (trauma team activation, neurosurgery, orthopaedics, or otolaryngology).  The remaining who did not require any specialty review included traumatic arrests (6%) or relatively minor injuries (20.1%).

The demographics and outcomes were within expectations. The inclusion criteria for pre-hospital trauma standby are more inclusive than the hospital’s trauma activation criteria, and rightly so. Further collaboration between the hospital and the SCDF may be explored to further streamline the pre-hospital trauma standby inclusion criteria.