Page:Derailment of Amtrak Passenger Train 188 Philadelphia, Pennsylvania May 12, 2015.djvu/43

NTSB transported to the hospital by family, friends, bystanders, or police—generally without medical care being provided. According to several studies, arriving at a trauma center by personal or police vehicle does not increase, and may decrease, mortality for patients with blunt or penetrating trauma.

For more than 25 years, it has been routine in Philadelphia for police officers to transport injured patients from the scene to the hospital without waiting for an ambulance to arrive. Most often, these are victims of gunshots and stab wounds, and they are transported without medical care on the way. Research in Philadelphia has demonstrated that the mode of hospital arrival does not negatively influence the victim's chance of survival.

In this accident, the majority of patients were transported by police vehicles or SEPTA buses without medical care on the way to the hospital. While some patients may have been triaged by EMS, most were not. As is the PPD's routine practice, the police officer driving the vehicle chose the destination. In at least one case, this meant a critically injured person was transported to a nontrauma hospital (Aria Health Frankford) and then had to be transferred to a higher level of care. Other patients may have experienced significant discomfort as they were transported by police vehicle or SEPTA bus with multiple broken bones. However, this investigation did not identify any negative health outcomes as a result of the means of transportation.

Consistent with the PPD's routine practice, police dispatch notified the hospital of the number of patients en route without providing vital signs, injury descriptions, or other medical details that would have been communicated if the patients were being transported by EMS. Nor did the police department communicate with EMS personnel regarding the destinations of the patients they transported. This resulted in at least 43 people arriving at Temple University Hospital and no patients arriving at Penn Presbyterian Medical Center directly from the scene, although the distance was similar and both are Level I trauma centers. (Two patients with serious injuries were subsequently transferred to Penn Presbyterian Medical Center from other facilities.) Passenger interviews described at least one police vehicle arriving at Temple University Hospital only to be waved off to another hospital before any of the injured got out of the car. The NTSB concludes that as a result of victims being transported to hospitals without coordination, some hospitals were overutilized while others were significantly underutilized during the response to the derailment. 33