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Helicopter primary retrieval: tasking who should do it?

Stephen Cameron1, Peter Pereira, Richard Mulcahy

  • 1Department of Emergency Medicine, Gosford Hospital, Gosford, New South Wales, Australia. stevecameron1@aapt.net.au

Emergency Medicine Australasia : EMA
|August 11, 2005
PubMed
Summary

Intensive care paramedics provide effective prehospital care, similar to emergency physicians, for high-acuity patients. However, paramedics are more likely to perform unnecessary helicopter retrievals for lower-acuity cases.

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Area of Science:

  • Emergency Medicine
  • Prehospital Care
  • Aeromedical Retrieval Systems

Background:

  • Cairns Base Hospital transitioned helicopter retrieval staffing from emergency physicians to intensive care paramedics in 2001.
  • This study evaluates changes in activation patterns and patient outcomes following the transition.

Purpose of the Study:

  • To compare patient outcomes and activation patterns between emergency physician-staffed and intensive care paramedic-staffed helicopter retrieval services.
  • To assess the efficacy of paramedics versus physicians in prehospital care.

Main Methods:

  • Retrospective chart review of 374 helicopter retrievals over four years (1999-2003).
  • Comparison of 30-day mortality, hospital length of stay, transfer rates, Revised Trauma Score, and emergency department discharge rates between physician and ambulance groups.

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Main Results:

  • Demographics were similar between the emergency physician group (n=211) and the ambulance group (n=163).
  • The ambulance group had a significantly higher rate of emergency department discharge without admission (33.1% vs. 14.7%, P=0.0001).
  • No significant differences in outcomes were observed for admitted patients.

Conclusions:

  • Intensive care paramedics demonstrate comparable efficacy to emergency physicians for high-acuity patient care.
  • The ambulance service exhibited a higher rate of clinically unnecessary taskings for lower-acuity patients.
  • Recommendations include enhanced clinical coordination with emergency physicians to reduce unnecessary aeromedical retrievals.