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Tom Avril
The Philadelphia Inquirer
PHILADELPHIA — As the number of gunshot and stabbing victims climbed in Philadelphia from 2014 to 2018, police officers took on a greater share of the job of transporting the wounded to hospital trauma centers, saving lives in the process.
That’s the conclusion of a new study Monday led by University of Pennsylvania researchers, who urged that other cities consider adopting the longtime Philadelphia practice known as “scoop and run.”
The authors found that in 2018, close to two-thirds of shooting and stabbing victims in the city were taken to trauma centers by police cruiser, up from one-third of the total in a previous Penn study of the practice from 2003 to 2007. As in the earlier study, the new analysis found that patients were just as likely to survive whether they were transported by cruiser or ambulance.
The researchers stressed that the success of police transport in no way represented a criticism of the Fire Department, which handles most of the trauma transport by ambulance.
When someone is bleeding profusely, the biggest factor in survival is a speedy trip to the hospital, said senior author Jeremy W. Cannon, the trauma section chief at Penn Medicine. So if a cruiser arrives on the scene first, as often happens, the officers should not wait, he said.
“They should just get to the trauma center as quickly as possible, whichever team is there,” he said.
As city gun violence has climbed even higher during the coronavirus pandemic, the police contribution in transporting victims appears to have been even more valuable, Cannon said. The year 2020 was not part of the study, but anecdotal evidence has been compelling, he said.
“In the last year, we’ve seen what I would call unexpected survivors,” he said. “We were able to get them there just in the nick of time.”
In a statement, Fire Commissioner Adam K. Thiel said he welcomed the police assistance, adding that in the last two years, the Fire Department ambulances have been the busiest in the country.
“We appreciate the contributions of our public safety and hospital partners toward our shared mission of saving lives across the city,” he said.
In addition to Cannon and others from Penn, coauthors of the study, published in JAMA Network Open, included a West Chester University mathematician.
Overall, victims of “penetrating trauma” were more likely to die when transported by police cruiser than by ambulance. But those patients had suffered more serious injuries to begin with.
When the researchers matched up victims from the two types of transport by severity of injury, they were equally likely to be alive after 24 hours, the study authors found.
By another measure — whether victims with the most severe injuries made it to the hospital alive — those transported by police cruiser fared a bit better than those in ambulances, the study authors found.
One limitation of the study was that the authors did not have details on how quickly the police cruisers and ambulances arrived at hospitals. They also had no data on which medical interventions were tried en route.
But previous research suggests that two common ambulance procedures — inserting a breathing tube and giving the person intravenous fluid — do not make much difference for trauma victims, Cannon said. The one technique that does make a big difference is using a tourniquet, he said. And Philadelphia police officers are allowed to use those.
“That’s really the most critical piece in the chain of survival, stopping the bleeding as soon as you possibly can,” he said.
That lesson was derived from the battlefield, said Cannon, a former Air Force surgeon who served in Iraq and Afghanistan.
For years, military physicians were reluctant to use tourniquets for fear that the belt-like devices would place soldiers at higher risk of eventual amputation, he said. But the latest evidence suggests that risk is relatively low, and that the risk is worth it when the person would otherwise bleed to death.
The new Penn study was based on 3,313 patients transported to trauma centers from January 2014 to December 2018. That total did not several categories of patients, including those younger than 18, those transported by private vehicle, helicopter, or walk-in, and those transferred from other facilities.
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