I have also worked at a Level 1 Trauma hospital, and I think it depends on the distance from the hospital and the degree of specialty care needed. Also, since Covid, there have been more and more staffing and capacity problems in ERs. Taking a critical patient to an ER with no available resus bays that is also boarding ICU patients due to a lack of ICU staffing is going to be less effective and less safe than going the extra distance to a hospital that does have the capacity to care for the patient. Studies from before 2020 are just not relevant anymore.
(I worked at a #1 trauma center for 16 years)
I was just stating what is the “public secret” and there is a lot of studies to back it
https://www.hopkinsmedicine.org/news/media/releases/hold_the_phone_an_ambulance_might_lower_your_chances_of_surviving_some_injuries
https://hub.jhu.edu/2017/09/20/emergency-transport-survival-rates-study-hopkins/
I could provide more links but those are the first couple from sites that I would trust
I have also worked at a Level 1 Trauma hospital, and I think it depends on the distance from the hospital and the degree of specialty care needed. Also, since Covid, there have been more and more staffing and capacity problems in ERs. Taking a critical patient to an ER with no available resus bays that is also boarding ICU patients due to a lack of ICU staffing is going to be less effective and less safe than going the extra distance to a hospital that does have the capacity to care for the patient. Studies from before 2020 are just not relevant anymore.