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Prehospital Triage of Pediatric Emergencies Treated by Helicopter Emergency Medical Services: A Population-Based

Emma Atsuko Tsuchiya1, Oscar Rosenkrantz2, Troels Martin Hansen3

  • 1Department of Anesthesiology, Surgery and Trauma Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Air Medical Journal
|August 23, 2025
PubMed

Insights

Helicopter emergency medical services (HEMS) generally triage critically ill children to the highest level of care. Higher 30-day mortality was observed in pediatric patients transported to tertiary emergency departments (EDs) versus local EDs.

Area of Science:

  • Pediatric Emergency Medicine
  • Emergency Medical Services Research
  • Trauma Care Systems

Background:

  • Helicopter emergency medical services (HEMS) are vital for rapid patient transport.
  • Critically ill pediatric patients are typically directed to tertiary emergency departments (EDs).
  • The effectiveness of HEMS triage for pediatric patients requires evaluation.

Purpose of the Study:

  • To assess if HEMS effectively triages critically ill pediatric patients to the highest level of care.
  • To compare 30-day mortality between pediatric patients treated by HEMS and admitted to tertiary versus local EDs.

Main Methods:

  • A cohort study analyzed pediatric patients (<18 years) managed by Danish HEMS from 2019-2024.
  • The primary outcome was 30-day mortality; secondary outcomes included severity scores and interventions.
  • Fisher's exact test was used for statistical comparisons.

Main Results:

  • Of 836 included patients, 30-day mortality was higher in tertiary EDs (5.4%) than local EDs (0.4%) (P < .001).
  • Tertiary ED patients had more critical National Advisory Committee for Aeronautics scores (42.4% vs. 10.4%) and interventions (35.6% vs. 10.4%).
  • Common diagnoses differed, with Injuries and Poisoning prevalent in tertiary EDs.

Conclusions:

  • HEMS appears to successfully triage the most critically ill pediatric patients to higher-level care.
  • Higher mortality in tertiary EDs supports the current triage strategy for critically ill children.
  • This study validates the critical role of HEMS in pediatric critical care access.
Abstract

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