Care of the Injured Patients at Nursing Stations and during Air Medical Transport

Nursing stations are the only access point into the health care system for some communities and have limited capabilities and resources. We describe characteristics of patients injured in Northern Ontario who present to nursing stations and require transport by air ambulance. Secondary objectives are to compare interventions performed at nursing stations with those performed by flight paramedics and to identify systemic gaps in trauma care.

A retrospective cohort study was performed of all injured patients transported by air ambulance from April 1, 2014, to March 31, 2015.

A total of 125 injured patients were transported from nursing stations. Blunt trauma accounted for 82.5% of injuries, and alcohol intoxication was suspected in 41.6% of patients. The most frequently performed interventions were intravenous fluids and analgesia. Paramedics administered oxygen 62.4% of the time, whereas nursing stations only applied in 8.8% of cases. Flight paramedics were the only providers to intubate and administer tranexamic acid, mannitol, or vasopressors.

Care for patients at nursing stations may be improved by updating the drug formulary based on gap analyses. Further research should examine the role of telemedicine support for nursing station staff and the use of point-of-care devices to screen for traumatic intracranial hemorrhage.