RT Journal Article SR Electronic T1 The golden hour of shock – how time is running out: prehospital time intervals in Germany—a multivariate analysis of 15, 103 patients from the TraumaRegister DGU® JF Emergency Medicine Journal JO Emerg Med J FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine SP 1048 OP 1055 DO 10.1136/emermed-2012-201962 VO 30 IS 12 A1 Hendrik Wyen A1 Rolf Lefering A1 Marc Maegele A1 Thomas Brockamp A1 Arasch Wafaisade A1 Sebastian Wutzler A1 Felix Walcher A1 Ingo Marzi A1 the TraumaRegister DGU YR 2013 UL http://emj.bmj.com/content/30/12/1048.abstract AB Objectives Although prehospital treatment algorithms have changed over the past years, the prehospital time of multiple trauma patients of some 70 min and the on-scene-treatment time (OST) of some 30 min have not changed since 1993. The aim of this study was to critically assess specific interventions and conditions at the scene in relation to their impact on prehospital rescue intervals. Methods We performed a retrospective data analysis of all multiple injured patients from the TraumaRegister DGU (English: German Trauma Society) from January 1993 to December 2010. Exclusion criteria were missing or implausible data regarding prehospital timelines. With OST as an independent variable, different models of multivariate regression were performed to identify parameters with relevant impact on the OST. Results 15 103 datasets were included in this study. Based on the mean OST of 32.7 (±18.6) min and a constant absolute term of 16.2 (±1.5) min, we identified seven procedures and nine environmental parameters with significant impact on OST. Intubation (9.3±0.8 min) and being a car occupant (8.0±0.8 min) were associated with the most prolonged OSTs. A Glasgow Coma Scale ≤8 (−4.5±0.7 min) and cardiopulmonary resuscitation (−2.8±1.7 min) resulted in its most relevant reduction. Admission to a Level III facility led to a reduced overall prehospital time (60.0±24.6 min) compared with Level I (70.0±28.5 min) and II (66.8±27.4 min) trauma centres. Conclusions This study identified characteristic interventions and conditions with significant impact on prehospital treatment times. Current treatment concepts should be re-evaluated with respect to these results.