Friday March 24 6:18 PM ET Get to the hospital -- quick! NEW YORK, Mar 24 (Reuters Health) -- When the ambulance arrives, should paramedics treat you at the scene, or get to the hospital right away? A new report suggests that they should ''scoop and run'' -- that is, the faster they get you to the hospital, the better.

In a review of 103 emergency cases at a Los Angeles trauma center, researchers at the University of Southern California found that among the most seriously injured, those who got themselves to the hospital arrived twice as quickly as those brought by emergency medical services (EMS).

Although these patients had similar rates of death and complications regardless of how they got to the hospital, there was a trend toward better outcomes with speedier transports.

``With some injuries -- gun shot wounds, in particular -- patients may do better if we just get them to the hospital,'' lead study author Dr. Edward E. Cornwell told Reuters Health. Cornwell, now head of trauma at Johns Hopkins Medical Institutions in Baltimore, Maryland, and his colleagues report their findings in the March issue of Archives of Surgery.

To compare transport times, Cornwell's team matched EMS and non-EMS patients by factors such as age, how injuries occurred, and injury severity. Most were male, and 80% were Hispanic. Patient interviews and official records were used to figure the time of injury. Among EMS patients, the time between injury and arriving at the hospital was ``amazingly consistent'' for all types of injury, Cornwell said.

In contrast, non-EMS patients got to the hospital more quickly if their injury was more serious. Among all patients with injuries such as gun shot wounds, non-EMS patients arrived at the hospital in an average of 15 minutes, compared with 28 minutes for EMS patients.

Patients, Cornwell said, seemed to recognize the severity of their own injuries, and their quick actions are the purest form of ``scoop and run.'' This argument holds that in some cases, such as when patients are bleeding profusely, speed should be the top concern.

States have varying protocols for what paramedics should do for patients on-scene. Emergency workers may try to stabilize patients by giving them intravenous fluids and try to prevent spinal injury by immobilizing them. These two measures, Cornwell said, are likely to do little for a seriously wounded, bleeding patient.

``This is not a slap at EMS,'' Cornwell stressed. ``It would be a disservice to tell people they should get themselves to a hospital when severely injured.'' Ambulances can break through traffic, and, Cornwell noted, most people don't know which hospitals are trauma centers equipped to handle critical injuries. ``To the public,'' he said, ``a hospital is a hospital.'' Rather, Cornwell said, this study suggests EMS should base on-scene measures on how patients were injured, rather than on across-the-board protocol. SOURCE: Archives of Surgery 2000;135:315-319.