Comparative Clinical Outcomes of Trauma Transport: Emergency Medical Services vs. Police Transport, A Systematic Review and Meta-Analysis

Authors

Vadym Shapovalov, Department of Emergency Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania.
Quincy K. Tran, Department of Emergency Medicine; Program in Trauma, The R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, Maryland.
Babak Sarani, Center for Trauma and Critical Care, Department of Surgery.
Mohammed Zohery, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
Amy Caggiula, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
Rahil Ashraf, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC.
Ali Pourmand, Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC. Electronic address: pourmand@email.gwu.edu.

Document Type

Journal Article

Publication Date

1-1-2026

Journal

The Journal of emergency medicine

Volume

80

DOI

10.1016/j.jemermed.2025.10.013

Keywords

Emergency Medical Services (EMS); injury outcomes; mortality; patient transport modalities; police transport; prehospital care; trauma; trauma care

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 (I = 66%) and surgical interventions (I = 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.

APA Citation

Shapovalov, Vadym; Tran, Quincy K.; Sarani, Babak; Zohery, Mohammed; Caggiula, Amy; Ashraf, Rahil; and Pourmand, Ali, "Comparative Clinical Outcomes of Trauma Transport: Emergency Medical Services vs. Police Transport, A Systematic Review and Meta-Analysis" (2026). GW Authored Works. Paper 8646.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/8646

Department

Emergency Medicine