The utility of physician-staffed helicopters for managing individuals who experience severe isolated head trauma / Journal of Rural Medicine

Objective: The authors retrospectively investigated prognostic factors for severe isolated head trauma in patients evacuated by a physician-staffed helicopter emergency medical service (HEMS) or ground ambulance using data from the Japan Trauma Data Bank (JTDB).Patients and Methods: This study was a retrospective analysis of data housed in the JTDB database. The study period was from January 2004 to May 2019. Subjects were divided into two groups according to the method of transportation: helicopter (i.e., HEMS), which included patients transported by a physician-staffed helicopter; and ambulance, which included patients transported by ground ambulance.Results: A total of 41,358 patients were enrolled in the study, including 2,029 in the helicopter group and 39,329 in the ambulance group. The ratio of males, median head Abbreviated Injury Scale and Injury Severity Scale (ISS) scores were significantly greater in the helicopter group than in the ambulance group, while the average age, median Glasgow Coma Scale, average Revised Trauma Score (RTS), and survival rate were significantly lower in the helicopter group than in the ambulance group. Of the variables that demonstrated statistical significance in the univariate analysis and classification of transportation and included in the multivariate analysis, the following were identified as significant predictors of survival outcomes: younger age, lower ISS, female sex, and greater RTS. HEMS was not a significant predictor of survival.Conclusion: The present study revealed no effect of HEMS transport on the outcomes of patients who experienced severe isolated head trauma compared with ground ambulance transportation. Further prospective studies, including an analysis of the operation time or distance traveled by the HEMS and the functional outcome(s) of patients with severe head injury transported by HEMS, are warranted.

Characteristics of Emergency Patients Transported by Helicopter on Jeju Island

PURPOSE: The study investigated the present state of helicopter patient transport system on Jeju Island with the aim of improving the helicopter emergency medical service system. METHODS: Electrical medical records of patients transported to Jeju National University Hospital by coast guard helicopter from March 2009 to November 2010 were retrospectively reviewed. The followings were analyzed in terms of patient demography, pre-hospital treatment and monitoring during transport, emergency severity index (ESI) score, outcomes and appropriateness of transportation. RESULTS: During the 19 months of the study, 35 patients were helicopter-transported. There were 18 illness patients (51%) and 17 trauma patients (49%). There were 11 ESI level I patients (31.4%) and 8 ESI level II patients (11.4%). Treatment and monitoring during transportation were rare. 15 patients (43%) were hospitalized and 10(28%) died. 16 (45.7%) patients were indicated to the helicopter transportation. CONCLUSION: The near-absence of treatment and monitoring during helicopter transportation is thought to be associated with the absence of firefighting helicopter and trained medical staff. Appropriate emergency patient transportation protocols are needed.

Analysis of Patients were Transported by 119 Helicopter from Mountain Accident Scenes in Seoul

PURPOSE: Geographic problems can make it difficult for rescue teams to access emergency patients in the mountains. We developed the aeromedical relief program in conjunction with fire department helicopter EMS teams. This study describes the clinical experience of patients transported from the mountains in this program. METHODS: We reviewed the employed protocols and the medical records of patients transported to our hospital from the mountains by the aeromedical transport system from June 2006 to June 2007. RESULTS: Thirty-one patients were transported by helicopter during the study period, most of them (84%) from Mt. Bukhan. The time interval from call for help to hospital arrival was 80+/-56 min, and rescue time alone was 30+/-24 min. Eleven patients (36%) were pronounced dead on arrival, and 11 patients were admitted for management. The number of trauma patients were 24 (77%), who had an average RTS score (excluding the 11 patients who expired before arrival) of 11.7+/-0.6. When the ground team and the aeromedical team were dispatched at the same time, the total transport time was 54.0+/-22.8 min, compared to 133.0 +/-75.7 min when the aeromedical team was dispatched only upon the request of the ground team, a large and statistically significant difference. CONCLUSION: This study suggests that the helicopter transport system can be successfully employed to achieve early access to patients in the mountains. To optimize the current program, cooperation between hospital and the regional helicopter EMS is required.