Redefining trauma deserts: novel technique to accurately map prehospital transport time
Background Prehospital transport time has been directly related to mortality for hemorrhaging trauma patients. ‘Trauma deserts’ were previously defined as being outside of a 5-mile radial distance of an urban trauma center. We postulated that the true ‘desert’ should be based on transport time rathe...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/8/1/e001013.full |
| _version_ | 1797367352620220416 |
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| author | Vanessa P Ho Leah C Tatebe Heena P Santry Ken Tatebe |
| author_facet | Vanessa P Ho Leah C Tatebe Heena P Santry Ken Tatebe |
| author_sort | Vanessa P Ho |
| collection | DOAJ |
| description | Background Prehospital transport time has been directly related to mortality for hemorrhaging trauma patients. ‘Trauma deserts’ were previously defined as being outside of a 5-mile radial distance of an urban trauma center. We postulated that the true ‘desert’ should be based on transport time rather than transport distance.Methods Using the Chicagoland area that was used to describe ‘trauma deserts,’ a sequential process to query a commercial travel optimization product to map transport times over coordinates that covered the entire urban area at a particular time of day. This produces a heat map representing prehospital transport times. Travel times were then limited to 15 minutes to represent a temporally based map of transport capabilities. This was repeated during high and low traffic times and for centers across the city.Results We demonstrated that the temporally based map for transport to a trauma center in an urban center differs significantly from the radial distance to the trauma center. Primary effects were proximity to highways and the downtown area. Transportation to centers were significantly different when time was considered instead of distance (p<0.001). We were further able to map variations in traffic patterns and thus transport times by time of day. The truly ‘closest’ trauma center by time changed based on time of day and was not always the closest hospital by distance.Discussion As the crow flies is not how the ambulance drives. This novel technique of dynamically mapping transport times can be used to create accurate trauma deserts in an urban setting with multiple trauma centers. Further, this technique can be used to quantify the potential benefit or detriment of adding or removing firehouses or trauma centers. |
| first_indexed | 2024-03-08T17:17:14Z |
| format | Article |
| id | doaj.art-c66f4a08ace64b9c93d504f9c0a2c9d7 |
| institution | Directory Open Access Journal |
| issn | 2397-5776 |
| language | English |
| last_indexed | 2024-03-08T17:17:14Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj.art-c66f4a08ace64b9c93d504f9c0a2c9d72024-01-03T11:00:09ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762023-11-018110.1136/tsaco-2022-001013Redefining trauma deserts: novel technique to accurately map prehospital transport timeVanessa P Ho0Leah C Tatebe1Heena P Santry2Ken Tatebe3Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA1 Department of Surgery, Northwestern University, Chicago, Illinois, USADepartment of Surgery, Kettering Hospital, Columbus, Ohio, USADepartment of Radiation Oncology, Rush University Medical Center, Chicago, Illinois, USABackground Prehospital transport time has been directly related to mortality for hemorrhaging trauma patients. ‘Trauma deserts’ were previously defined as being outside of a 5-mile radial distance of an urban trauma center. We postulated that the true ‘desert’ should be based on transport time rather than transport distance.Methods Using the Chicagoland area that was used to describe ‘trauma deserts,’ a sequential process to query a commercial travel optimization product to map transport times over coordinates that covered the entire urban area at a particular time of day. This produces a heat map representing prehospital transport times. Travel times were then limited to 15 minutes to represent a temporally based map of transport capabilities. This was repeated during high and low traffic times and for centers across the city.Results We demonstrated that the temporally based map for transport to a trauma center in an urban center differs significantly from the radial distance to the trauma center. Primary effects were proximity to highways and the downtown area. Transportation to centers were significantly different when time was considered instead of distance (p<0.001). We were further able to map variations in traffic patterns and thus transport times by time of day. The truly ‘closest’ trauma center by time changed based on time of day and was not always the closest hospital by distance.Discussion As the crow flies is not how the ambulance drives. This novel technique of dynamically mapping transport times can be used to create accurate trauma deserts in an urban setting with multiple trauma centers. Further, this technique can be used to quantify the potential benefit or detriment of adding or removing firehouses or trauma centers.https://tsaco.bmj.com/content/8/1/e001013.full |
| spellingShingle | Vanessa P Ho Leah C Tatebe Heena P Santry Ken Tatebe Redefining trauma deserts: novel technique to accurately map prehospital transport time Trauma Surgery & Acute Care Open |
| title | Redefining trauma deserts: novel technique to accurately map prehospital transport time |
| title_full | Redefining trauma deserts: novel technique to accurately map prehospital transport time |
| title_fullStr | Redefining trauma deserts: novel technique to accurately map prehospital transport time |
| title_full_unstemmed | Redefining trauma deserts: novel technique to accurately map prehospital transport time |
| title_short | Redefining trauma deserts: novel technique to accurately map prehospital transport time |
| title_sort | redefining trauma deserts novel technique to accurately map prehospital transport time |
| url | https://tsaco.bmj.com/content/8/1/e001013.full |
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