Recently a friend directed my attention to This Article knowing my interests and background lay in critical care. I found the article interesting enough to analyse here.
"OPALS project -- likely the world's most important research into the care provided to patients before they reach hospital". Admittedly a soft point for me to start my argument on. No British authority recognises OPALS(Ontario Prehospital Advanced Life Support). And this is for good reason, Canadian medical authorities do not have the financing, legal privileges, or experience to carry out any detailed studies in comparison with the authorities of the US and United Kingdom.
Secondly prehospital conditions are radically different in Canada. Their EMT's are trained based on different (yet seemingly equally as effective) protocols. Their ambulances and terrain would also effect the stability of a trauma patient. However my largest point is that there is a massive distance between hospitals throughout most of Canada, even in their urban centers. Where UK ambulances have an 8 minute ORCON(Operational Research Consultancy) targets for all catagory A calls. Most Canadians would be lucky if they were injured within an hour of the nearest ambulance. I believe the figures this study has collected should implement a reconsideration of long-haul ambulance journeys with a trauma patient, however there is no suggestion that the study has taken into consideration duration.