Helicopter transport of pediatric versus adult trauma patients

Conflicting reports exist regarding the appropriate utilization of helicopter transport for victims of trauma. It has been suggested that adult patients are more severely injured compared with pediatric patients when transported by helicopter. The purpose of this study was to determine whether injury severity and survival probability in pediatric trauma patients were similar to those for adults when helicopter transport was utilized at a suburban trauma center.

The authors conducted a retrospective review of all trauma patients transported by helicopter from the accident scene. Patients were identified from the Christiana Care Health System trauma registry from January 1995 to November 1999. Pediatric patients were defined as those aged 15 years and younger. Data collected were utilized to determine injury severity score (ISS), revised trauma score (RTS), and survival probability.

Nine hundred sixty-nine patients were transported; 143 were pediatric. There was no statistical difference noted in ISS (14.21 adult, 12.76 pediatric; p = 0.1506) and RTS (7.23 adult, 7.31 pediatric; p = 0.1832). Mean length of stay was less for the pediatric group (7.5 days adult, 5.2 days pediatric; p = 0.008). Survival probabilities were likewise similar for the two groups, yet the difference met statistical significance (0.92 adult, 0.95 pediatric; p = 0.03).

Pediatric patients transported from the accident scene by helicopter have similar ISSs and RTSs compared with adults. These data suggest that prehospital selection criteria for the two groups are similar.