Is air medical scene response for illness appropriate?

The purpose of this study was to determine the appropriateness of air medical scene response for illness. The study consisted of a retrospective chart review of a two-helicopter urban air medical transport program with a transport volume of 1,700 flights annually. During the study period, January 1988 through March 1990, 68 patients were transported by helicopter from scene of illness to a tertiary care facility. In cases in which patients could be managed appropriately locally, air transport was deemed unnecessary. Of the 68 patients with illness, 40 were males and 28 were females; the average age was 39.2 years (from a range of 0 to 93). The average transport time was 46.3 minutes. Dispatch diagnoses were cardiac arrest (20), seizure (14), myocardial infarction (8), overdose (6), stroke (5), labor (4), respiratory distress (3) and miscellaneous (8). The discharge (final) diagnosis was different from dispatch diagnoses in 10 patients (14.7%). Fifty-four patients (79.4%) required no tertiary care, and 30 of them were discharged from the emergency department or were pronounced dead there or at the scene. The results of the study indicate air medical response to scene of illness did not appear justified in this study. Transport should be local, by ground, with subsequent tertiary care being arranged as needed. Further prospective study is warranted.