Original ResearchAnalysis of Transport to an American College of Surgeons Level I Trauma Center
Section snippets
Methods
This single-center retrospective study was completed using data from the Trauma Registry at Morristown Medical Center (MMC), an American College of Surgeons level I regional trauma center. The quality of the data was checked by reviewing data entry, missing data, and outliers to ensure accuracy and consistency. Every trauma patient evaluated at MMC was entered into this database, along with detailed information about their hospital course. Patients admitted between January 1, 2016, and December
Results
The total number of ALS trauma patient transports to MMC in 2016 was 903. One hundred ninety-seven (21.82%) patients were transported via helicopter, and 706 (78.18%) were transported via ground ambulance. The study population consisted of 89 (9.86%) patients aged 0 to 18 years, 336 (37.21%) patients aged 19 to 49 years, and 478 patients (52.93%) aged 50 years and older.
Compared with the GEMS group, the HEMS group was found to be significantly younger, have a higher rate of motor vehicle
Discussion
Contrary to our hypothesis, we did not find a difference in mortality between patients transported by HEMS and patients transported by GEMS. Other studies have shown similar results.11, 12, 13 However, we believe our current use of HEMS is adequate because there are no differences in mortality, yet the patients transported by HEMS had more significant injuries (higher ISS and higher percentage of ED disposition to the operating room). Interestingly, a study published in Surgery17 found that
Conclusion
The literature on the usefulness and benefits of HEMS versus GEMS is mixed. Studies from individual hospitals or hospital groups have reported different results, possibly because of varying criteria for triaging to HEMS and varying distances covered by EMS. In our institution, we did not find a significant difference in mortality or hospital length of stay between HEMS and GEMS patients although this may be caused by a smaller sample size. We believe that our current use of HEMS is satisfactory
Acknowledgment
The authors thank Jaroslaw W. Bilaniuk, MD; Jennifer Theobald, BS; and Gabriella Elizabeth Foster, BS.
References (22)
- et al.
Does out-of-hospital EMS time affect trauma survival
Am J Emerg Med
(1995) - et al.
Mortality following helicopter versus ground transport of injured children
Injury
(2017) - et al.
Helicopter transport improves survival following injury in the absence of a time-saving advantage
Surgery
(2016) Injuries. World Health Organization. WHO Web site
- et al.
Overuse of helicopter transport in the minimally injured: a health care system problem that should be corrected
J Trauma Acute Care Surg
(2015) - et al.
Increasing trauma deaths in the United States
Ann Surg
(2014) - et al.
Association of prehospital mode of transport with mortality in penetrating trauma: a trauma system-level assessment of private vehicle transportation vs ground emergency medical services
JAMA Surg
(2018) - et al.
Helicopter emergency medical services for adults with major trauma
Cochrane Database Syst Rev
(2015) - et al.
Association between helicopter vs ground emergency medical services and survival for adults with major trauma
JAMA
(2012) - et al.
Development and validation of the Air Medical Prehospital Triage (AMPT) score for helicopter transport of trauma patients
Ann Surg
(2016)
Outcomes after helicopter versus ground emergency medical services for major trauma–propensity score and instrumental variable analyses: a retrospective nationwide cohort study
Scand J Trauma Resusc Emerg Med
Cited by (2)
Association Between Mode of Transportation and Outcomes in Penetrating Trauma Across Different Prehospital Time Intervals: A Matched Cohort Study
2021, Journal of Emergency MedicineCitation Excerpt :Lower HEMS dispatch can also result from adherence to some state-specific HEMS dispatch criteria, which usually limit nonbeneficial helicopter use in short distances. This rationale is supported by previous studies, which demonstrated that GEMS are typically faster than HEMS if the distance to the appropriate receiving hospital is shorter than 5–10 miles and are more cost-efficient (26–28). Other studies also reported no significant survival differences between air and ground transport if patients are located in urban environments with proximity to trauma centers with associated safety and cost-efficiency benefits (24,29,30).
How to Better Triage Trauma Patients for Helicopter Transport
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