Better trauma care. How Maryland does it

Area of Science:

• Emergency Medical Services
• Aviation Medicine
• Public Health Systems

Background:

• Established in 1970, Maryland's statewide airborne emergency medical system was pioneered by the Maryland State Police and the University of Maryland.
• The system was inspired by military medical evacuation models, aiming to provide rapid transport for critically injured patients.
• It represents a unique public service collaboration between state police and a major university hospital.

Purpose of the Study:

• To describe the structure and function of Maryland's comprehensive emergency medical services (EMS) system.
• To highlight the role of the Maryland State Police Aviation Division and the Maryland Institute for Emergency Medical Services Systems (MIEMSS).
• To evaluate the effectiveness of this model system and advocate for its national replication.

Main Methods:

• The system integrates aircraft, state troopers, a central communications center (SYSCOM), ambulance/fire rescue services, and specialized trauma/burn centers.
• Utilizes 12 Aerospace Dauphin AS365N helicopters staffed by pilots and paramedics, operating from eight strategic locations.
• Funding is secured through an annual surcharge on automobile registrations.

Main Results:

• The Maryland State Police Aviation Division operates a highly efficient medevac service, coordinating scene transport and patient referral to specialized care facilities.
• MIEMSS oversees the system's components, ensuring seamless emergency medical care delivery.
• An on-scene evaluation demonstrated successful critical care transport, exemplified by moving an injured child to a Level I Pediatric Trauma Center.

Conclusions:

• Maryland's integrated EMS model, featuring a robust aviation division and centralized coordination, effectively serves citizens.
• The system's success provides compelling evidence for its performance and potential for saving lives.
• Replication of this exemplary emergency medical system nationwide could significantly improve outcomes for critically injured individuals.