Emergency Medical Service (EMS) systems in developed and developing countries

Bahman Sayyar Roudsari, Avery B. Nathens, Carlos Arreola-Risa, Peter Cameron, Ian Civil, Giouli Grigoriou, Russel L. Gruen, Thomas D. Koepsell, Fiona E. Lecky, Rolf L. Lefering, Moishe Liberman, Charles N. Mock, Hans Jörg Oestern, Elenie Petridou, Thomas A. Schildhauer, Christian Waydhas, Moosa Zargar, Frederick P. Rivara

Research output: Contribution to journalArticlepeer-review

102 Scopus citations


Objectives: To compare patient- and injury-related characteristics of trauma victims and pre-hospital trauma care systems among different developed and developing countries. Method: We collated de-identified patient-level data from national or local trauma registries in Australia, Austria, Canada, Greece, Germany, Iran, Mexico, New Zealand, the Netherlands, the United Kingdom and the United States. Patient and injury-related characteristics of trauma victims with injury severity score (ISS) >15 and the pre-hospital trauma care provided to these patients were compared among different countries. Results: A total of 30,339 subjects from one or several regions in 11 countries were included in this analysis. Austria (51%), Germany (41%) and Australia (30%) reported the highest proportion of air ambulance use. Monterrey, Mexico (median 10.1 min) and Montreal, Canada (median 16.1 min) reported the shortest and Germany (median: 30 min) and Austria (median: 26 min) reported the longest scene time. Use of intravenous fluid therapy among advanced EMS systems without physicians as pre-hospital care providers, varied from 30% (in the Netherlands) to 55% (in the US). The corresponding percentages in advanced EMS systems with physicians actively involved in pre-hospital trauma care, excluding Montreal in Canada, ranged from 63% (in London, in the UK) to 75% in Germany and Austria. Austria and Germany also reported the highest percentage of pre-hospital intubation (61% and 56%, respectively). Conclusion: This study provides an early look at international variability in patient mix, process of care, and performance of different pre-hospital trauma care systems worldwide. International efforts should be devoted to developing a minimum standard data set for trauma patients.

Original languageEnglish (US)
Pages (from-to)1001-1013
Number of pages13
Issue number9
StatePublished - Sep 1 2007
Externally publishedYes


  • Advanced Life Support
  • Basic Life Support
  • Developed and developing countries
  • Emergency Medical Service (EMS) systems
  • Endotracheal intubation
  • Intravenous fluid therapy
  • Pre-hospital trauma care

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine


Dive into the research topics of 'Emergency Medical Service (EMS) systems in developed and developing countries'. Together they form a unique fingerprint.

Cite this