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A new study suggests that, following a gunshot or stab wound, individuals might be better off getting into a friend's car and instructing them to drive straight to the nearest hospital, rather than waiting for an ambulance after calling 911.
The research, published in the *Journal of the American Medical Association*, examined 103,029 cases of penetrating injuries — specifically gunshot and knife wounds — in American cities from the National Trauma Data Bank. Of these cases, recorded between 2010 and 2012, 9.4% were fatal. After accounting for injury severity and other factors, the study found that patients who reached a hospital by private vehicle had a 60% lower risk of death compared to those transported by ambulance, according to Michael W. Wandling, MD, the lead author.
Wandling, a clinical scholar at the American College of Surgeons, notes that he wouldn't universally recommend taking a ride from a friend to the emergency room after a penetrating injury instead of waiting for paramedics, but adds, 'in certain situations, it’s something to consider.'
While the study did not analyze ambulance response times, Wandling believes that speed plays a crucial role in saving victims of stabbing or gunshot wounds. Emergency medical transport involves a call to a dispatcher, communication with the ambulance crew, and the travel time to the location, while hopping into a friend’s car and apologizing for the blood stains involves far less waiting.
Despite the early application of a tourniquet and the ability of ambulances to navigate traffic with sirens and lights on, the study suggests that survival chances decrease if you wait through these initial steps in the process.
However, Scott Moore, an attorney from Massachusetts who advises ambulatory services, doesn't believe skipping the ambulance is a wise recommendation. He argues that non-medical individuals should not be handling transportation in a medical emergency. 'What if something goes wrong along the way?' he questions.
Rob Lawrence, the chief operating officer of the Richmond (Virginia) Ambulance Authority, is doubtful of the study's findings due to its lack of data on ambulance response times. He notes that minority communities sometimes avoid using 911 due to a lack of trust in authorities or fear of police involvement. As a result, some participants in the study may have arranged their own transport to the ER when an ambulance could have been nearby.
The study sample reflects a significant proportion of minorities: 47.9 percent were black, 26.3 percent were white, and 18.4 percent were Hispanic. These demographics align with those typically seen at urban trauma centers for such injuries. Additionally, the majority of patients studied were male (87.6 percent) and younger than the general population, with a mean age of 32.3 years. Wandling confirmed that race was accounted for in his analysis.
Although Lawrence advocates for more research to improve ambulance response times in some regions, he maintains that non-professionals should not be responsible for transporting a wounded person to the hospital. 'Without a trained professional in the vehicle, your friend could bleed out and die, and the consequences could be disastrous,' he warns.
Wandling, the author of the study, believes that this research should serve as a catalyst for reviewing the entire emergency medical services (EMS) system and finding ways to enhance response times.
In the meantime, if you're going to handle it on your own, Wandling offers some guidance.
"Ensuring that the injured person is transported safely is key," he advises. "Running red lights and causing accidents won't help anyone." He also stresses the need for using GPS: "Getting lost won't be beneficial."
Lastly, it might be a good idea to search "trauma center near me." Not all emergency rooms are equipped to handle a gunshot wound to the chest within minutes of arrival. If there is a trauma center nearby, "find a hospital with trauma surgeons or neurosurgeons, or one that can bring one in quickly," Wandling suggests.
He adds that penetrating injuries are a unique type of trauma, and the study's findings should not be applied to other medical emergencies. In cases of heart attacks, EMTs provide the best initial response through CPR and defibrillation. However, some gunshot and knife wounds involve life-threatening blood loss that requires immediate surgical intervention. "These injuries involve significant damage to major blood vessels," Wandling explains. "They must be addressed surgically within a very short time frame."
