Are scene flights for penetrating trauma justified?

Area of Science:

• Trauma care
• Emergency medical services
• Aeromedical transport

Background:

• Penetrating injuries pose significant challenges in urban settings.
• The efficacy of helicopter scene flights for trauma patients requires evaluation.
• Emergency Medical Services (EMS) capabilities vary between basic and advanced life support.

Purpose of the Study:

• To assess the medical effectiveness of helicopter scene flights for patients with noncranial penetrating injuries.
• To determine if helicopter transport from the scene hastens arrival at a trauma center.
• To identify the proportion of patients requiring medical interventions beyond the scope of ground EMS.

Main Methods:

• Retrospective review of 122 patients with noncranial penetrating injuries.
• Analysis of helicopter evacuations from the scene to a Level I trauma center.
• Comparison of medical interventions provided by flight crews versus ground EMS (ALS and BLS).

Main Results:

• The majority of patients were critically injured, with a 15.6% mortality rate.
• Helicopter transport did not hasten trauma center arrival for any patient.
• Only 4.9% of patients required interventions by flight crews beyond ground EMS capabilities (2.5% for ALS, 6.7% for BLS).

Conclusions:

• Helicopter scene flights for noncranial penetrating injuries in this metropolitan area were not medically efficacious.
• Flights did not expedite trauma center arrival and offered limited advanced care beyond ground EMS.
• Scene flights should be restricted to critically injured patients needing advanced interventions or significantly faster transport.