Health Policy Manag.  2018 Dec;28(4):411-422. 10.4332/KJHPA.2018.28.4.411.

Effectiveness of the Trauma Team-Staffed Helicopter Emergency Medical Service

Affiliations
  • 1Health Policy Division, Gyeonggi Province, Suwon, Korea.
  • 2Department of Public Health, Yonsei University Graduate School, Seoul, Korea.
  • 3Institute of Health Services Research, Yonsei University, Seoul, Korea.
  • 4Department of Preventable Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 5Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea. ajoutraumacenter@gmail.com
  • 6South Gyeonggi Regional Trauma Center, Ajou University Hospital, Suwon, Korea.
  • 7Gyeonggi Disaster and Safety Headquarters, Suwon, Korea.

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.

Keyword

Helicopter emergency medical service; Injury; Injury Severity Score; Trauma centers
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