Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study

Introduction This study aims to compare the trauma system before and after implementing a physician‐staffed helicopter emergency medical service (PS‐HEMS). Our hypothesis was that PS‐HEMS would reduce time from injury to definitive care for severely injured patients. Methods This was a prospective,...

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Published in:	Acta anaesthesiologica Scandinavica Vol. 57; no. 5; pp. 660 - 668
Main Authors:	HESSELFELDT, R., STEINMETZ, J., JANS, H., JACOBSSON, M.-L. B, ANDERSEN, D. L., BUGGESKOV, K., KOWALSKI, M., PRÆST, M., ØLLGAARD, L., HÖIBY, P., RASMUSSEN, L. S.
Format:	Journal Article
Language:	English
Published:	England Blackwell Publishing Ltd 01-05-2013 Wiley Subscription Services, Inc
Subjects:	Adolescent Adult Aged Aged, 80 and over Air Ambulances - statistics & numerical data Denmark Emergency Medical Services - methods Emergency Medicine Emergency services Female Humans Injury Severity Score Male Middle Aged Physicians Prospective Studies Time Factors Trauma centers Wounds and Injuries - therapy Young Adult Denmark
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Summary:	Introduction This study aims to compare the trauma system before and after implementing a physician‐staffed helicopter emergency medical service (PS‐HEMS). Our hypothesis was that PS‐HEMS would reduce time from injury to definitive care for severely injured patients. Methods This was a prospective, controlled, observational study, involving seven local hospitals and one level I trauma centre using a before and after design. All patients treated by a trauma team within a 5‐month period (1 December 2009–30 April 2010) prior to and a 12‐month period (1 May 2010–30 April 2011) after implementing a PS‐HEMS were included. We compared time from dispatch of the first ground ambulance to arrival in the trauma centre for patients with Injury Severity Score (ISS) > 15. Secondary end points were the proportion of secondary transfers and 30‐day mortality. Results We included 1788 patients, of which 204 had an ISS > 15. The PS‐HEMS transported 44 severely injured directly to the trauma centre resulting in a reduction of secondary transfers from 50% before to 34% after implementation (P = 0.04). Median delay for definitive care for severely injured patients was 218 min before and 90 min after implementation (P < 0.01). The 30‐day mortality was reduced from 29% (16/56) before to 14% (21/147) after PS‐HEMS (P = 0.02). Logistic regression showed PS‐HEMS had an odds ratio (OR) for survival of 6.9 compared with ground transport. Conclusions Implementation of a PS‐HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30‐day mortality.
Bibliography:	TrygFonden ArticleID:AAS12052 ark:/67375/WNG-FDR1BSB6-0 istex:E5F7DC2C6907E5E773EA663355D06D5621CEE0A8 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0001-5172 1399-6576
DOI:	10.1111/aas.12052