Limitations
traumas, trauma
VEHICLE ACCIDENT, SECONDARY
Findings from the present study must be considered in light of several limitations. While the data in this secondary analysis represent adult patients with major trauma treated at 12 Level I trauma centers across North America, details on locations of traumas and EMS (distance to the scene, personnel staffing, and experience of the providers) in the geographic location were not included. Therefore, the analyses were unable to be stratified based on urban versus rural locations. Circumstances surrounding the trauma may also have influenced the time to definitive care but were not available for analysis. For example, patients in motor vehicle accidents who required extrication may have experienced prolonged delays in treatment and hospital arrival. Finally, these data were collected as part of a clinical trial to examine the impact of ratios of blood components used in massive transfusions for patients with major trauma and were therefore not powered to address researcher questions.