Flight vibrations and bleeding in helicoptered patients with pelvic fracture

Depending on their amplitude and frequency, vibrations may facilitate bleeding and worsen the prognosis of patients with pelvic fractures transported by helicopter emergency medical services (HEMS). We measured the range of frequencies and amplitudes of forced vibrations produced by the helicopter used by the HEMS of the Italian Friuli Venezia Giulia region on the pelvis of transported persons. We performed 3 flight tests with 3 different volunteers (mass 70, 80, and 90 kg, respectively) loaded on the helicopter's stretcher and recorded the amplitudes and frequencies of vibrations through a triaxis sensor placed on the HEMS stretcher in the pelvis area. The flight profile planned was identical for each of the 3 iterations. Over the whole flight, the frequencies of vibration were between 26.4 and 53.5 Hz, and the greastest amplitude was 0.035 mm. The vibrations recorded in the helicopter may facilitate bleeding in unstable fractures. In the management of patients with pelvic fractures, HEMS crews should provide prehospital care that includes the use of specific splinting devices in addition to the spinal board, which allows an early immobilization of fractures and the limitation of pelvic motion.