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Validity of helicopter emergency medical services dispatch criteria for traumatic injuries: a systematic review
Akkie N Ringburg1, Gijs de Ronde, Stephen H Thomas
1Department of Surgery-Traumatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. a.ringburg@erasmusmc.nl
Objective:
This review provides an overview of the validity of Helicopter Emergency Medical Services (HEMS) dispatch criteria for severely injured patients.
Methods:
A systematic literature search was performed. English written and peer-reviewed publications on HEMS dispatch criteria were included.
Results:
Thirty-four publications were included. Five manuscripts discussed accuracy of HEMS dispatch criteria. Criteria based upon Mechanism of Injury (MOI) have a positive predictive value (PPV) of 27%. Criteria based upon the anatomy of injury combined with MOI as a group, result in an undertriage of 13% and a considerable overtriage. The criterion 'loss of consciousness' has a sensitivity of 93-98% and a specificity of 85-96%. Criteria based on age and/or comorbidity have a poor sensitivity and specificity.
Conclusion:
Only 5 studies described HEMS dispatch criteria validity. HEMS dispatch based on consciousness criteria seems promising. MOI criteria lack accuracy and will lead to significant overtriage. The first categories needing revision are MOI and age/comorbidity.
