title: Prehospital Transport for Pediatric Trauma: A Comparison of Private Transport and Emergency Medical Services.
abstract: OBJECTIVE
  We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome.
  
  
  METHODS
  We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8. We categorized unstable injuries as head injuries, spinal injuries, or proximal long bone fractures. Major trauma was defined as the presence of any of the following: ISS of 16 or higher, intensive care unit (ICU) admission or death.
  
  
  RESULTS
  Ninety children were studied, including 27 major trauma and 66 unstable injuries; 69 patients (77%) used PT. Most patients with major trauma (17/27, 63%) and unstable injuries (50/66, 76%) used PT. Compared with EMS patients, PT patients were younger, smaller, took longer for emergency department physician review and stayed longer in the emergency department. Rates of ICU admission were similar in both groups, but length of stay in ICU and total hospital stay were shorter in the PT group despite similar proportions of major trauma and unstable injuries as well as median ISS. Each group had 1 mortality.
  
  
  CONCLUSIONS
  Most children with major trauma and unstable injuries were brought by PT, risking deterioration en route. Nevertheless, this does not seem to translate to worse outcomes overall.
authors.affiliation: From the Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore.
authors.forename: Yea-Chyi
authors.initials: YC
authors.lastname: Lin
authors.forename: York Tien
authors.initials: YT
authors.lastname: Lee
authors.forename: Jasmine Xun Yi
authors.initials: JXY
authors.lastname: Feng
authors.forename: Li Wei
authors.initials: LW
authors.lastname: Chiang
authors.forename: Shireen Anne
authors.initials: SA
authors.lastname: Nah
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012846:Singapore; D014187:Transportation of Patients / Q000379:methods / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*