Comparison of optimal triage and treatment during transport via Doctor-HEMS and EMS-HEMS

ABSTRACT

Objective@#Helicopter emergency medical services (HEMS) have been used for prompt and appropriate transport of trauma patients. South Korea operates a dual HEMS system consisting of the Doctor-HEMS and the EMS-HEMS. This study compared the relevance of evaluation and treatment during transport using the two HEMS systems. @*Methods@#This was a retrospective, single-center cohort study, and 180 trauma patients transported via HEMS from July 2013 to June 2021 were enrolled in the analysis. We compared the appropriateness of evaluation and management between the Doctor-HEMS and the EMS-HEMS using a newly developed checklist based on Advanced Trauma Life Support protocol. @*Results@#In terms of the performance score, the EMS-HEMS was higher with respect to basic management at the scene, especially cervical immobilization and warming (P<0.001). On the other hand, the Doctor-HEMS showed a higher score with respect to monitoring and procedures during transport (P<0.001). The total performance score was higher in the Doctor-HEMS group than in the EMS-HEMS group (P=0.022). @*Conclusion@#The Doctor-HEMS generally showed better performance in the transport of trauma patients, although it showed relatively lower performance with respect to basic care at the scene. The EMS-HEMS displayed a lower performance in monitoring and management during air transport. It is necessary to develop a common checklist for both the Doctor-HEMS and the EMS-HEMS. Through continuous efforts and feedback, the transportation of trauma patients can be improved.