Emergency aeromedical services in Ireland: a retrospective study for "MEDEVAC112"

Area of Science:

• Trauma care
• Emergency medicine
• Aeromedical services

Background:

• Evaluating the efficiency and dispatch criteria of a new emergency aeromedical service (EAS) is crucial for trauma centers.
• Tallaght Hospital's level II trauma center implemented EAS, necessitating an analysis of its initial performance.

Purpose of the Study:

• To assess the dispatch criteria used for emergency aeromedical services (EAS) to Tallaght Hospital.
• To estimate the baseline efficiency of time-critical patient management via EAS.
• To evaluate patient transfers across different catchment areas.

Main Methods:

• Retrospective analysis of consecutive patients transported by EAS to Tallaght Hospital in 2013.
• Matching EAS data with electronic patient records and conducting chart reviews.
• Calculating estimated road travel times and evaluating dispatch criteria using American College of Surgeons (ACS) guidelines.

Main Results:

• 48 out of 52 EAS cases were matched; 25% were discharged without specialist input, suggesting acceptable over-triage.
• Seven patients died within 24 hours, with only one admitted under specialist care.
• 80% of admissions were managed by orthopaedics, with significant requirements for operative, ICU, and inter-facility transfers.

Conclusions:

• The 25% of patients managed solely in the Emergency Department align with acceptable over-triage rates per ACS guidelines.
• Dispatch criteria analysis showed no statistical difference between over-triaged and appropriately triaged patients.
• Further research is recommended to optimize EAS activation criteria and enhance overall service delivery.