Local Emergency Medical Services Adherence to Recommended 10-Minute Limit of Scene Time for Trauma Patients

The American College of Surgeons Committee on Trauma recommends a maximal Emergency Medicine Services (EMS) scene time of 10 minutes for traumatic emergency patients to give the best chance of survival. This is also known as the “platinum 10.” In accordance, the New Jersey EMS Clinical Practice Protocols & Guidelines state that trauma patient scene times should be limited to “less than 10 minutes post-extrication”. Previous research done at University Hospital in Newark, NJ showed average and median scene times for patients with traumatic injuries between 11/1/24 – 10/31/25 was 12m 55s and 11m 0s, respectively. This seeks to determine reasons for these delays to target future intervention to reduce scene times and thereby mortality.

To identify areas of improvement, EMS reports between 11/1/24 – 10/31/25 for trauma runs, identified via National EMS Information System (NEMSIS) data elements eInjury.03 and eInjury.04, were extracted and analyzed for patterns. The narrative reports as well as the Scene Time Delay were read to identify potential causes of scene delay. Scene Time was calculated between Time of Arrival at Patient until Time of Leaving Scene.

714 run reports were identified as trauma patients. 400 had scene times of 10 min, 24 of these were duplicate levels of care, leaving 376 unique patient transports. 166 (44%) had no identifiable reason in their narrative or chart for a prolonged scene time, 21 (6%) were caused by cardiac arrest, 6 (2%) by intubation, and 48 (13%) by Basic Life Support (BLS) waiting for Advance Life Support/Paramedics (ALS).

The areas found to have the biggest opportunity for improvement were runs that had been delayed on scene due to working cardiac arrest on scene, paramedics performing intubation, and BLS crews that delayed on scene for ALS arrival or assessment. Documentation about scene delays could also be improved to better characterize other areas of potential improvement.