Use of helicopters for retrieval of trauma patients: A geospatial analysis

Abstract

BACKGROUND Helicopters are widely used to facilitate the transport of trauma patients, from the scene of an incident to the hospital. However, the use of helicopters may not always be appropriate. The aim of this project was to conduct a geospatial analysis of helicopter transport to a Level I trauma center. METHODS Retrospective geospatial analysis of trauma registry data, 2013 to 2018. We included all adult (≥16) trauma patients brought to the trauma center directly from the scene. Data were geocoded and analyzed using arcGIS. Drive times and flight times were calculated using Google Maps. Flight times included the time required to reach the incident location. RESULTS Two thousand eight hundred ninety-three patients were identified, and 1,911 had incident locations recorded and were therefore included in the analysis. The median age was 41 years (interquartile range [IQR], 27–58 years). Twenty-four percent of the patients had suffered severe injuries (Injury Severity Score [ISS], 16–25), 17% very severe injuries (ISS > 25), 24% moderately severe injuries, and 36% minor injuries (ISS, 1–8). The overall geographical distribution was centroidal, although with a concentration of case volume in the vicinity, and to the northeast, of the trauma center. Median flight time was 60 minutes (IQR, 52–69 minutes), and median drive time 65 minutes (IQR, 54–86 minutes). In 33% of the patients, the calculated drive time to the trauma center was shorter than the calculated flight time when considering the time for the helicopter to reach the scene. CONCLUSION The majority of patients taken to our level I trauma center by helicopter are injured in relatively close proximity. One in four patients is severely or very severely injured, but one third of the patients have only minor injuries. Over a quarter of trauma patients might have reached hospital more quickly if they had been taken by road, rather than helicopter. LEVEL OF EVIDENCE Epidemiological/geographical study, level V.

Is NBATS-2 up to the Task? Actual vs. Predicted Patient Volume Shifts With the Addition of Another Trauma Center

“…Although analyzing air transport can be complex, such as the fact that in some regions, over 25% of trauma patients transported by helicopter would have reached the hospital more quickly by ground transport, air transport is an essential aspect of EMS response and trauma system planning. 18 While we certainly plan on analyzing aeromedical transport as a component of trauma system planning in future studies, we did not feel that this was appropriate for our first large-scale trial of the NBATS-2 tool as it would require a thorough analysis of the relationship between the interests of private helicopter companies in Tennessee and the logistics of air transport, as well as an interpretation of how these factors affect access to care. The goal of this study was to determine the practicality of the tool, and in our region, we felt adding aeromedical complexities were not appropriate at this time.…”

Advantages and disadvantages of using helicopters for air medical evacuation of victims with traumas (literature review)

“…Во многих зарубежных исследованиях выявлено, что время прибытия на место происшествия наземных бригад EMS было в 1,3-3 раза (на 5-13 мин) меньше, чем бригад HEMS [4,37,55]. Ретроспективный анализ показал, что в штате Алабама (США) 33 % пациентов, доставленных на вертолете в травмоцентр I уровня, достигли бы его быстрее при транс портировке наземной службой скорой помо щи, которая прибывала к месту происшествия первой [43].…”

A Geospatial Examination of Specialist Care Accessibility and Impact on Health Outcomes for Patients With Acute Traumatic Spinal Cord Injury in Nsw, Australia: A Whole  Population Record Linkage Study

“…Epidemiological, health services studies are increasingly using geospatial methods (11)(12)(13) to better understand and target both injury prevention and post-injury care (14). Triage optimisation using geospatial data and scenario modelling has demonstrated signi cantly reduced time to SCIU admission in a Canadian study (15).…”