The Ambulance Science Podcast: Philadelphia’s Failure

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Philadelphia’s failure to fund EMS forces “meat wagon-tactics” by police while surgeons ignore the real problem, say Scot Phelps and Maria Werner.

Key Points:

  • Philadelphia Fire EMS is severely underfunded, with a unit-hour utilization of 1.0, meaning they’re busy 100% of the time, leading to a delayed response time
  • As a result, critical penetrating trauma patients are transported by police, without any care, in the back of prisoner vans to trauma centers
  • But rather than advocating for more ambulances, especially in this era of limiting police scope creep, surgeons consistently try to justify the police transport model

Previous: The National EMS Scope of Practice Episode

Further Reading

Slow to Respond: What Takes Philly Ambulances So Long?

Brian X. McCrone and George Spencer 

NBC Philadelphia

February 27, 2019 

Medical Emergency? Philadelphia’s Fire Department to the Rescue

The Dose 

October 4, 2019

Shanoor Seervai 

Philadelphia City Council, Committee of the Whole 

Transcript

May 1st 2019

Articles

2011 – Injury-adjusted Mortality of Patients Transported by Police Following Penetrating Trauma

Roger A. Band, MD, John P. Pryor, MD, David F. Gaieski, MD, Edward T. Dickinson, MD, Daniel Cummings, MD, and Brendan G. Carr, MD, MS

2014 – Severity-Adjusted Mortality in Trauma Patients Transported by Police 

Roger A. Band, MD, Rama A. Salhi, BS, MHS, Daniel N. Holena, MD, Elizabeth Powell, MD, Charles C. Branas, PhD, and Brendan G. Carr, MD, MS

2016 – Police transport versus ground EMS. A trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes

Wandling, Michael W. MD; Nathens, Avery B. MD, PhD; Shapiro, Michael B. MD; Haut, Elliott R. MD, PhD

2017 – Patient Characteristics and Temporal Trends in Police Transport of Blunt Trauma Patients: A Multicenter Retrospective Cohort Study 

Elinore J. Kaufman, Sara F. Jacoby, Catherine E. Sharoky, Brendan G. Carr, M. Kit Delgado, Patrick M. Reilly & Daniel N. Holena 

2020 – Beyond survival: the broader consequences of prehospital transport by police for penetrating trauma 

Sara F Jacoby, Charles C Branas, Daniel N Holena, Elinore J Kaufman 

2021 – Police Transport for Penetrating Trauma—Lessons From Patients in Philadelphia

Kenji Inaba, MD; Gregory J. Jurkovich, MD

2021-Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania

Eric Winter, BS; Allyson M. Hynes, MD; Kaitlyn Shultz, BS; Daniel N. Holena, MD; Neil R. Malhotra, MD; Jeremy W. Cannon, MD

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