Background Traumatic injury is a leading cause of premature death and health loss in New Zealand. Outcomes following injury are very time sensitive, and timely access of critically injured patients to advanced hospital trauma care services can improve injury survival.

Objective This cross-sectional study will investigate the epidemiology and geographic location of prehospital fatal injury deaths in relation to access to prehospital emergency services for the first time in New Zealand.

Design and study population Electronic Coronial case files for the period 2008–2012 will be reviewed to identify cases of prehospital fatal injury across New Zealand.

Methods The project will combine epidemiological and geospatial methods in three research phases: (1) identification, enumeration, description and geocoding of prehospital injury deaths using existing electronic injury data sets; (2) geocoding of advanced hospital-level care providers and emergency land and air ambulance services to determine the current theoretical service coverage in a specified time period and (3) synthesising of information from phases I and II using geospatial methods to determine the number of prehospital injury deaths located in areas without timely access to advanced-level hospital care.

Discussion The findings of this research will identify opportunities to optimise access to advanced-level hospital care in New Zealand to increase the chances of survival from serious injury. The resulting epidemiological and geospatial analyses will represent an advancement of knowledge for injury prevention and health service quality improvement towards better patient outcomes following serious injury in New Zealand and similar countries.