R. Field1, K. Hunter1, A. Goldenberg Sandau1 1Cooper University Hospital, Trauma, Camden, NJ, USA
Introduction: Previous research has demonstrated that rapid transport of gunshot wound (GSW) victims improves morbidity and reduces mortality. Our previous work has demonstrated and the installation of ShotSpotter™ (SS), a gunfire detection system in the city of Camden, NJ and the liberal use of “scoop and go” police transport decreased response and transport time for gunshot wound (GSW) victims. The purpose of this study was to evaluate the continued efficacy of ShotSpotter™ and compare dispatch and transport time trends of patients with both police and EMS transport which occurred with and without the activation of ShotSpotter™ (SS), in the time periods of 2016-2021 in the city of Camden.
Methods: This was a single center, retrospective observational study which evaluated all shootings victims at a Level 1 urban trauma center from 2016 to 2021. Demographics, response time, transport time, and clinical data was collected for patients transported by both police (PD) and EMS with ShotSpotter (SS) activation and those with no ShotSpotter (NSS). Exclusion criteria included non PD or EMS transport as well as charts where complete data were not available. Independent T-test, Mann Whitney U test, Chi square Test, and linear regression to correct for transport time and method of transport was used to compare outcomes (p<0.05).
Results: A total of 267 victims of GSW met inclusion criteria with 77 EMS-SS ,41 EMS-NSS ,116 PD-SS, and 33 PD-NSS . When comparing response and transport times in a linear progression form 2016-2021, both response times improved with PD-SS 2 min [IQR 1-3] and PD-NSS 2 min [IQR 0.5-4.5] vs EMS-SS 4 min [IQR 2-6] and EMS-NSS 3 min [IQR 1.75-5] (p=0.001). In addition, PD-SS and EMS-SS transport times, there was a significant decrease in time with median of 5 min [IQR 3-7.75] vs 9 min [IQR 7-11] (p<0.001). Police initiated transport specifically PD-SS transport volume has stayed consistent with 33.3% of transports in 2016 to 33.4% in 2021 (p=0.06) with a peak in 2021 (68.3%).There was a concominent increase in PD-NSS transport 4% to 37.9% (p<0.001). EMS-SS transport has decreased from 54.7% to 6.9% (p<0.001) and EMS-NSS has increased from 8.0% to 20.7% (p=0.018). Victims of PD-SS transport had a higher shock index (p=0.009) received more blood products (p=0.025), had less field interventions (p<0.001), and underwent more resuscitative thoracotomies (p<0.001).
Conclusions: The presence of ShotSpotter™ technology in a small urban setting continues to increase the rate of police transport of gunshot wound victims. Furthermore, since the initiation of ShotSpotter™ the critical time of dispatch and transport for both police and EMS has shown durable improvement.
