title: Changes in rural trauma prehospital times following the Rural Trauma Team Development Course training.
abstract: BACKGROUND
  The majority of the US population live in urban areas, yet more than half of all trauma deaths occur in rural areas. The Rural Trauma Team Development Course (RTTDC) is developed to improve the outcomes of rural trauma and we aimed to study its effect on patient transfer.
  
  
  METHODS
  Trauma referrals 2 years before the RTTDC training were compared with referrals 2 years after the course.
  
  
  RESULTS
  Of the 276 studied patients, 97 were referred before the RTTDC training and 179 patients were referred after the course. Transfer acceptance time was significantly shorter after the RTTDC training (139.2 ± 87.1 vs 110 ± 66.3 min, P = .003). The overall transfer time was also significantly reduced following the RTTDC training (257.4 ± 110.8 vs 219.2 ± 86.5 min, P = .002). Patients receiving pretransfer imaging had a significantly higher transfer time both before and after RTTDC training (all Ps < .01). Mortality was nearly halved (6.2% vs 3.4%) after the RTTDC training.
  
  
  CONCLUSIONS
  The RTTDC training was associated with reduced transfer acceptance time and reduced transfer time.
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Mahdi
authors: M
authors: Malekpour
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Nina
authors: N
authors: Neuhaus
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: David
authors: D
authors: Martin
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Kenneth
authors: K
authors: Widom
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Megan
authors: M
authors: Rapp
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Diane
authors: D
authors: Leonard
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Susan
authors: S
authors: Baro
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: James
authors: J
authors: Dove
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Marie
authors: M
authors: Hunsinger
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Joseph
authors: J
authors: Blansfield
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Mohsen
authors: M
authors: Shabahang
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA.
authors: Denise
authors: D
authors: Torres
authors: Section of Trauma and Acute Care Surgery, Department of Surgery, Geisinger Medical Center, Danville, PA, USA. Electronic address: jlwild@geisinger.edu.
authors: Jeffrey
authors: J
authors: Wild
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D010360:Patient Transfer / Q000706:statistics & numerical data*; D010414:Pennsylvania / Q000453:epidemiology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration*; D012424:Rural Population; D013997:Time Factors; D014193:Trauma Centers; D014194:Traumatology / Q000193:education*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology*; D055815:Young Adult
keywords: Outcome; Rural Trauma Team Development Course; Time; Transfer; Trauma