Comparative Clinical Outcomes of Trauma Transport: Emergency Medical Services vs. Police Transport, A Systematic Review and Meta-Analysis.
The Journal of emergency medicine · 2025-10-10 · Meta-analysis
Abstract
BACKGROUND: In many urban settings, police transport (PT) is increasingly used as an alternative to traditional Emergency Medical Services (EMS). PT follows a "scoop and run" strategy, aiming to minimize prehospital interventions to rapidly deliver patients to the nearest trauma center. Conversely, EMS teams typically provide stabilizing medical care on site before transport. OBJECTIVES: This study aimed to compare outcomes, specifically rates of surgical intervention and mortality, for patients transported by police vs. EMS. METHODS: PubMed, Scopus, and Cochrane databases were searched from inception to January 1, 2025 for studies meeting inclusion criteria. A random-effects meta-analysis was performed to assess the primary outcome of mortality for PT vs. EMS, and the secondary outcome of surgical intervention in penetrating injuries. Study quality was evaluated using the Newcastle-Ottawa Scale; heterogeneity was assessed with Q-statistics and I² values. RESULTS: Ten studies met criteria, totaling 112,570 patients: 100,716 (89%) transported via EMS and 11,854 (11%) by police. All-cause mortality was 13% (12,742/100,716) for EMS patients vs. 25% (2922/11,854) for PT patients. Police transport was associated with a 1.5-fold higher mortality rate (odds ratio 1.50, 95% confidence interval 1.34-1.69, p < 0.001). No statistically significant difference was found in surgical intervention rates for penetrating injuries (odds ratio 1.19, 95% confidence interval 0.98-1.45, p = 0.082). Heterogeneity was significant for both mortality (I2 = 66%) and surgical interventions (I2 = 74%). CONCLUSION: Police transport was associated with higher odds of all-cause mortality compared with EMS, with no difference in surgical intervention rates. Prospective, methodologically robust studies are needed to guide future practice.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Mortality & survival · Fire service & police · Urban
Related articles
- Mode of transport and prehospital interventions in urban penetrating trauma: A systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma. (J Trauma Acute Care Surg, 2026)
- Police transport of firearm-injured patients-more often and more injured. (J Trauma Acute Care Surg, 2021)
- Outcomes in EMS-transported attendees from events at a large indoor arena. (Prehosp Emerg Care, 2003)
- Rethinking trauma transport: Mortality and length of stay in non-EMS transported patients. (Injury, 2026)
- Detect, Dispatch, Drive: A Study of ShotSpotter Acoustic Technology and Transport of Gunshot Victims. (J Surg Res, 2024)
- Remoteness and emergency care pathways for ambulance-attended atrial fibrillation: a population-based linked cohort study. (Int J Cardiol Heart Vasc, 2026)