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Direct Air Versus Ground Transport Predictors for Rural Pediatric Trauma

Andrew B Starnes1, Babawale Oluborode1, Curtis Knoles1

  • 1University of Oklahoma School of Community Medicine, Tulsa, OK.

Air Medical Journal
|May 9, 2018
PubMed

Insights

In rural areas, pediatric trauma patients are more likely to receive helicopter transport (HEMS) over ground ambulance (GEMS) due to longer distances and severe injuries. Factors like lower Glasgow Coma Scale and multisystem trauma influence this decision.

Area of Science:

  • Pediatric Trauma Care
  • Emergency Medical Services
  • Rural Health

Background:

  • Traumatic injuries are a leading cause of mortality in children.
  • Emergency medical services transport is common in pediatric trauma cases.
  • Understanding transport modality selection is crucial for optimal patient outcomes.

Purpose of the Study:

  • To identify factors associated with helicopter emergency medical services (HEMS) transport versus ground emergency medical services (GEMS) for pediatric trauma patients in a rural setting.
  • To analyze the relationship between patient characteristics, injury severity, and transport mode selection.
  • To inform triage protocols for pediatric trauma in rural environments.

Main Methods:

  • Retrospective case-control study of pediatric trauma patients (<18 years) from 2005-2014.
  • Data sourced from the Oklahoma State Trauma Registry.
  • Multivariate regression analysis to identify factors associated with HEMS vs. GEMS transport.

Main Results:

  • 50.8% of patients were transported by HEMS.
  • Increased distance to trauma centers, lower Glasgow Coma Scale, multisystem injury, intubation, motor vehicle collision injuries, and elevated heart rate were associated with higher odds of HEMS transport.
  • Distance was the strongest predictor for HEMS utilization.

Conclusions:

  • Key determinants for HEMS triage in rural pediatric trauma include distance to trauma centers and injury severity.
  • Clinical factors and geographical distance significantly influence the choice between HEMS and GEMS.
  • Optimizing triage protocols can improve access to specialized care for critically injured children in rural areas.
Abstract

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