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Use of an ambulance-based helicopter retrieval service
The Australian and New Zealand Journal of Surgery
|July 20, 2000
Summary
Paramedic-staffed helicopter services benefit trauma care regionally, but protocols lead to overtriage. Helicopter use is seldom beneficial for trauma cases within 35 km of the trauma center.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Aeromedical Services
Background:
- John Hunter Hospital serves as a major trauma center for a vast region.
- A paramedic-staffed, protocol-driven helicopter primary retrieval service is in place for trauma patients.
Purpose of the Study:
- To evaluate the overtriage rate associated with current trauma helicopter protocols.
- To determine the impact of the helicopter retrieval service on patient outcomes.
Main Methods:
- Analysis of trauma database for helicopter arrivals in 1996.
- Expert panel review of 184 primary retrievals using a consensus model.
- Assessment of time delays, likelihood of benefit, and potential harm.
Main Results:
- 8% of 3087 trauma patients arrived by helicopter; 67.6% had low injury severity scores.
- 1.7% of patients experienced potential harm, 17.3% benefited, and 81.0% had no attributable benefit.
- Helicopter retrieval within 35 km of the trauma center showed minimal benefit.
Conclusions:
- The helicopter service provides regional trauma care benefits despite a majority of retrievals being for minor injuries.
- Potential harm exists due to delays and bypassing local hospitals, especially in critical cases.
- Primary helicopter tasking for trauma within 35 km of the major trauma center is rarely beneficial.