Effectiveness of the Trauma Team-Staffed Helicopter Emergency Medical Service
10.4332/KJHPA.2018.28.4.411
- Author:
Tea youn KIM
1
;
Sang Ah LEE
;
Eun Cheol PARK
;
Yo HUH
;
Kyoungwon JUNG
;
Junsik KWON
;
Jonghwan MOON
;
Jiyoung KIM
;
Juryang KIM
;
Kyungjin HWANG
;
Seong Keun YUN
;
John Cook Jong LEE
Author Information
1. Health Policy Division, Gyeonggi Province, Suwon, Korea.
- Publication Type:Original Article
- Keywords:
Helicopter emergency medical service;
Injury;
Injury Severity Score;
Trauma centers
- MeSH:
Aircraft;
Clinical Decision-Making;
Emergencies;
Emergency Medical Services;
Humans;
Injury Severity Score;
Mortality;
Resuscitation;
Retrospective Studies;
Survival Rate;
Transportation;
Trauma Centers
- From:Health Policy and Management
2018;28(4):411-422
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center. METHODS: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ≥15 years. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital). RESULTS: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group. CONCLUSION: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.
