In Palestine, trauma is considered as the seventh leading cause of death. In most cases death occurs before hospital arrival. Although of the conflict and large numbers of causali-ties in Palestine, no studies have examined trauma care in Palestine. The aims of this study were to investigate pre-hospital care provided by emergency medical system for road traffic accidents patients in Nablus, Palestine, in 2017 and follow up those patients to assess their outcome and hospital length of stay (LOS). The Palestinian Red Crescent Society archive was searched for road traffic accidents patients in 2017 that were transported by ambulance to the emergency department, and then patients were followed up in their receiving hospitals. The New Injury Severity Score (NISS) and the New Trauma Score (NTS) were used to stratify injury severity.Out of 307 patients, 77.52% were males and 22.48% were females with mean age of (32 ± 14.51) years. About 84.08% were discharged by doctors after completing thera-py. NISS has mean of 4.1 and hospital LOS mean was 32.2 hours. Mean of NTS at scene was 10.63 and 10.59 at arrival with mean of differences 0.04. Response and Transfer time means were 6.05 and 17.5 minutes and the ranges were (0 – 56) and (3 - 45) minutes, respec-tively. Only Oxygen administration, splint, and dressing were significantly different between the emergency medical system and the hospitals (p value < 0.01). Hospital LOS had signifi-cant correlation only with NISS (p value < 0.01) and NTS at scene (p value=0.02).The trauma system in Palestine has some weakness especially in organization and documentation. Hospital LOS does not reflect the patient clinical situation and many stay for non-medical causes. Prevention of unnecessary hospitalization can decrease the economic burden.

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