Helicopter use in rural trauma

Shepherd, Matthew Vincent; Trethewy, Christopher; Kennedy, John F.; Davis, Lin

doi:10.1111/j.1742-6723.2008.01135.x

Cited by 20 publications

(22 citation statements)

References 36 publications

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“…Our results regarding distances travelled by HEMS in regional areas are consistent with previous research in NSW [18]. Compared to a meta-analysis from the US of HEMS pre-hospital care times for trauma [19], our results showed HEMS in NSW have longer times in all categories.…”

Section: Discussionsupporting

confidence: 90%

“…The predominance of road trauma reported in our study is similar to previous findings in other jurisdictions [22-24] although the proportion of incidents was slightly less than that previously reported in NSW [18,25]. The majority of patients attended by HEMS were assessed to be clinically stable and had normal physiology, although data limitations precluded a true assessment of illness severity.…”

Section: Discussionsupporting

confidence: 86%

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Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

Taylor

Liu²,

Bruce

et al. 2012

BMC Health Serv Res

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BackgroundDespite numerous studies evaluating the benefits of Helicopter Emergency Medical Services (HEMS) in primary scene responses, little information exists on the scope of HEMS activities in Australia. We describe HEMS primary scene responses with respect to the time taken, the distances travelled relative to the closest designated trauma hospital and the receiving hospital; as well as the clinical characteristics of patients attended.MethodsClinical service data were retrospectively obtained from three HEMS in New South Wales between July 2008 and June 2009. All available primary scene response data were extracted and examined. Geographic Information System (GIS) based network analysis was used to estimate hypothetical ground transport distances from the locality of each primary scene response to firstly the closest designated trauma hospital and secondly the receiving hospital. Predictors of bypassing the closest designated trauma hospital were analysed using logistic regression.ResultsAnalyses included 596 primary missions. Overall the HEMS had a median return trip time of 94min including a median of 9min for activation, 34min travelling to the scene, 30min on-scene and 25min transporting patients to the receiving hospital. 72% of missions were within 100km of the receiving hospital and 87% of missions were in areas classified as ‘major cities’ or ‘inner regional’. The majority of incidents attended by HEMS were trauma-related, with road trauma the predominant cause (44%). The majority of trauma patients (81%) had normal physiology at HEMS arrival (RTS = 7.84). We found 62% of missions bypassed the closest designated trauma hospital. Multivariate predictors of bypass included: age; presence of spinal or burns trauma; the level of the closest designated trauma hospital; the transporting HEMS.ConclusionOur results document the large distances travelled by HEMS in NSW, especially in rural areas. The high proportion of HEMS missions that bypass the closest designated trauma hospital is a seldom mentioned benefit of HEMS transport. These results along with the characteristics of patients attended and the time HEMS take to complete primary scene responses are useful in understanding the benefit HEMS provides and the services it replaces.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

Taylor

Liu²,

Bruce

et al. 2012

BMC Health Serv Res

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“…It has been estimated that HEMS misses 20% to 25% of their calls compared to 5% for ground ambulance (Bruhn et al 1993) due to severe weather conditions. For distances less than 50 kilometers ground transportation was faster in optimum conditions (Shepherd et al 2008) Utilizing HEMS to decrease the time to advance medical treatment (see Figure 2.8 and 2.9 for comparison) is increasingly accepted in North America (Danielson 2009 (Weerheijm et al 2012;Lukovits et al 2013). Additionally important advantages include the aerial view of an accident/injury scene that only a helicopter provides and the ability to access a site where geographical and topographical impediments prevent ground access (Sullivent, Faul, and Wald 2011).…”

Section: 5: Debate On Delivery Modesmentioning

confidence: 97%

“…Emergency In Northern BC, trauma patients are subject to being transported by ground over long distances up to 10 hours because HEMS is not available thus reducing the chance of survival (Oppe and De Charro 2001 ;Shepherd et al 2008;Hesselfeldt et al 2013). Research has shown that an estimated thirteen extra patients with major trauma could survive each year if attended by a helicopter (Nicholl et al 1995;Thomas et al 2002;Brown et al 2010;Hankins 2010;Hameed et al 2010;Sullivent, Faul, & Wald 2011;Hesselfeldt et al 20 13).…”

Section: 4: Existing Emergency Medical Service Modelmentioning

confidence: 99%

“…Delays in discovering an incident, EMS response times, and transport inevitably result in a disproportionate number of on-scene deaths and short times to death (Shepherd et al 2008). Simons et al (2010) identified limitations in the Northern BC trauma infrastructure as the need for functional local no-refusal policies, centralized and coordinated trauma capabilities inregion with or without a designated trauma center, and access to in-region trauma related continued professional development.…”

Section: Introductionmentioning

confidence: 99%

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Need for helicopter emergency medical services (HEMS) in rural British Columbia

Squire¹

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Currently, there is no dedicated helicopter emergency medical service (HEMS) in Northern British Columbia (BC). Injuries to workers in BC result in the loss of more economically productive years than heart disease and cancer combined and cost nearly $2.8 billion per year. Nearly three quarters of all people who die of trauma-related conditions in Northern BC do so before they can be brought to a hospital; 82% in Northwestern BC, compared to 12% in Metro Vancouver (Cameron 2007;McKenna 2013). Minimizing the time from injury to optimal trauma care through the utilization of HEMS has been adopted as an essential component of emergency care infrastructures Globally.The purpose of this paper is to examine the opportunities, challenges and needs of a dedicated helicopter emergency medical system to service the remote regions of Northern BC.lll

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Possible Geographical Barriers to Trauma Center Access for Vulnerable Patients in the United States

Hsia

Shen²

2011

Arch Surg

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Objective To study whether traditionally vulnerable populations have worse geographic access to trauma centers. Design A cross-sectional analysis using data from the American Hospital Association Annual Survey from 2005 linked with zip code–level data from the US Census. We used a multinomial logit model to examine the odds of having difficult as opposed to easy access to trauma centers for a given subgroup of vulnerable populations. Setting and Participants Population in rural and urban communities as defined by zip codes in the United States. Main Outcome Measures Each community’s distance to the nearest trauma center (levels I–III). Results In urban areas, 67% of the population had easy access to trauma centers and 12% had difficult access compared with 24% and 31% in rural areas, respectively. Areas with higher shares of the following vulnerable population groups had higher risks (odds ratios) of facing difficult access to trauma center services in 2005: foreign born in urban areas (1.65 for a medium share and 2.18 for a high share [both P < .01]); African American in urban and rural areas (1.25 for a medium share and 1.35 for a high share, respectively [both P < .05]); and near-poor in urban and rural areas (1.52 [P < .05] and 1.69 [P < .01] for a high share, respectively). Conclusions A significant segment of the US population (representing 38.4 million people) does not have access to trauma care within 1 hour of driving time. Moreover, certain vulnerable groups are at higher risk than others for worse access to trauma centers. Stakeholders and health care planners should consider these factors in the development of trauma systems because a mismatch of potential need and access could signal inefficiencies in the delivery of care.

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Helicopter use in rural trauma

Cited by 20 publications

References 36 publications

Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

Need for helicopter emergency medical services (HEMS) in rural British Columbia

Possible Geographical Barriers to Trauma Center Access for Vulnerable Patients in the United States

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