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Mode of transport ground vs air

Shetal C Patel, Stephen Murphy, Scott Penfil, Debra Romeo, James H Hertzog
OBJECTIVE: The aim of the study was to evaluate the impact of ground versus air transport and use of pediatric specialty versus generalist transport teams on outcomes of pediatric trauma victims requiring interfacility transport. METHODS: A retrospective review of our hospital's trauma registry database was performed. Children with traumatic injuries who were transported from a referring hospital by either our pediatric specialty transport team or an outside generalist transport team were included in the analysis...
May 1, 2017: Pediatric Emergency Care
Stephen D Cassivi, Karlyn E Pierson, Bettie J Lechtenberg, Francis C Nichols, K Robert Shen, Mark S Allen, Dennis A Wigle
OBJECTIVE: The study objective was to determine whether air travel in the immediate postoperative period after anatomic pulmonary resection is associated with increased morbidity or mortality. METHODS: All patients undergoing anatomic pulmonary resection at the Mayo Clinic (2005-2012) were identified and sent surveys querying their mode of transportation home after hospital dismissal and any complications encountered during or shortly after this travel. This included pneumonia, hospital readmission, deep venous thrombosis/pulmonary embolism, and specific pleural complications (pneumothorax, empyema, or chest tube placement)...
May 2017: Journal of Thoracic and Cardiovascular Surgery
Stephanie F Polites, Martin D Zielinski, Aodhnait S Fahy, Amy E Wagie, Christopher R Moir, Donald H Jenkins, Scott P Zietlow, Elizabeth B Habermann
INTRODUCTION: Injured children may be transported to trauma centers by helicopter air ambulance (HAA); however, a benefit in outcomes to this expensive resource has not been consistently shown in the literature and there is concern that HAA is over-utilized. A study that adequately controls for selection biases in transport mode is needed to determine which injured children benefit from HAA. The purpose of this study was to determine if HAA impacts mortality differently in minimally and severely injured children and if there are predictors of over-triage of HAA in children that can be identified...
May 2017: Injury
Joshua B Brown, Mark L Gestring, Francis X Guyette, Matthew R Rosengart, Nicole A Stassen, Raquel M Forsythe, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry
BACKGROUND: The Air Medical Prehospital Triage (AMPT) score was developed to identify injured patients who may benefit from scene helicopter emergency medical services (HEMS) transport. External validation using a different data set is essential to ensure reliable performance. The study objective was to validate the effectiveness of the AMPT score to identify patients with a survival benefit from HEMS using the Pennsylvania Trauma Outcomes Study registry. METHODS: Patients 16 years or older undergoing scene HEMS or ground EMS (GEMS) transport in the Pennsylvania Trauma Outcomes Study registry 2000-2013 were included...
February 2017: Journal of Trauma and Acute Care Surgery
Amanda Calhoun, Martin Keller, Junxin Shi, Celeste Brancato, Kathy Donovan, Diana Kraus, Julie C Leonard
INTRODUCTION: Studies show that pediatric trauma centers produce better outcomes and reduced mortality for injured children. Yet, most children do not have timely access to a pediatric trauma center and require stabilization locally with subsequent transfer. Investigators have demonstrated that pediatric transport teams (PTT) improve outcomes for critically ill children; however, these studies did not differentiate outcomes for injured children. It may be that moderate to severely injured children actually fare worse with PTT due to slower transport times inherent to their remote locations and thus delays in important interventions...
March 2017: Prehospital Emergency Care
Nasim Ahmed
OBJECTIVES: The purpose of the study was to review the impact on survival of trauma victims who were transported via helicopter ambulance versus ground transportation and who received cardiopulmonary resuscitation (CPR) within 1 hour of hospital arrival. METHODS: A retrospective analysis of the trauma patients who underwent CPR within 1 hour of arrival to the trauma centers and transported either via air or ground ambulances was performed. Data were extracted from the Research Data Set 2007-2010 from the American College of Surgeons National Trauma Data Bank...
April 2016: Southern Medical Journal
Greg M Borst, Stephen W Davies, Brett H Waibel, Kenji L Leonard, Shane M Rinehart, Mark A Newell, Claudia E Goettler, Michael R Bard, Nathaniel R Poulin, Eric A Toschlog
BACKGROUND: Helicopter emergency medical service (HEMS) transport of trauma patients is costly and of unproven benefit. Recent retrospective studies fail to control for crew expertise and therefore compare highly trained advance life support with less-trained basic life support crews. The purpose of our study was to compare HEMS with ground, interfacility transport while controlling for crew training. We hypothesized that patients transported by HEMS would experience shorter interhospital transport time and reduced mortality...
August 2014: Journal of Trauma and Acute Care Surgery
Timothy A Mixon, Luis Colato
BACKGROUND: Patients suffering ST segment elevation myocardial infarction (STEMI) requiring transfer from a non-percutaneous coronary intervention (PCI) hospital to a PCI-capable hospital often have prolonged treatment times. OBJECTIVE: For STEMI transfers, we changed from air to ground transportation, and carefully documented the impact on treatment times. METHODS: This is a retrospective report between two hospitals within one STEMI system...
August 2014: Journal of Emergency Medicine
Norah A Foster, Dawn M Elfenbein, Wayne Kelley, Christopher R Brown, Carolyn Foley, John E Scarborough, Steven N Vaslef, Mark L Shapiro
BACKGROUND CONTEXT: The use and need of helicopter aeromedical transport systems (HEMSs) in health care today is based on the basic belief that early definitive care improves outcomes. Helicopter aeromedical transport system is perceived to be safer than ground transport (GT) for the interfacility transfer of patients who have sustained spinal injury because of the concern for deterioration of neurologic function if there is a delay in reaching a higher level of care. However, the use of HEMS is facing increasing public scrutiny because of its significantly greater cost and unique risk profile...
July 1, 2014: Spine Journal: Official Journal of the North American Spine Society
Hagen Andruszkow, Rolf Lefering, Michael Frink, Philipp Mommsen, Christian Zeckey, Katharina Rahe, Christian Krettek, Frank Hildebrand
INTRODUCTION: Physician-staffed helicopter emergency medical services (HEMS) are a well-established component of prehospital trauma care in Germany. Reduced rescue times and increased catchment area represent presumable specific advantages of HEMS. In contrast, the availability of HEMS is connected to a high financial burden and depends on the weather, day time and controlled visual flight rules. To date, clear evidence regarding the beneficial effects of HEMS in terms of improved clinical outcome has remained elusive...
2013: Critical Care: the Official Journal of the Critical Care Forum
Blair A Wormer, Greg P Fleming, Ashley B Christmas, Ronald F Sing, Michael H Thomason, Toan Huynh
BACKGROUND: Aeromedical transport (AMT) is an effective but costly means of rescuing critically injured patients. Although studies have shown that it improves survival to hospital discharge compared with ground transportation, an efficient threshold or universal criteria for this mode of transport remains to be established. Herein, we examined the effect of implementing a Trauma Advisory Committee (TAC) initiative focused on reducing AMT overtriage (OT) rates. METHODS: TAC outreach coordinators implemented a process improvement (PI) initiative and collected data prospectively from January 2007 to December 2011...
July 2013: Journal of Trauma and Acute Care Surgery
Eileen M Bulger, Danielle Guffey, Francis X Guyette, Russell D MacDonald, Karen Brasel, Jeffery D Kerby, Joseph P Minei, Craig Warden, Sandro Rizoli, Laurie J Morrison, Graham Nichol
BACKGROUND: There is ongoing controversy about the relative effectiveness of air medical versus ground transportation for severely injured patients. In some systems, air medical crews may provide a higher level of care but may require longer transport times. We sought to evaluate the impact of mode of transport on outcome based on analysis of data from two randomized trials of prehospital hypertonic resuscitation. METHODS: Injured patients were enrolled based on prehospital evidence of hypovolemic shock (systolic blood pressure ≤70 mm Hg or systolic blood pressure = 71-90 mm Hg with heart rate ≥108 bpm) or severe traumatic brain injury (TBI; Glasgow Coma Scale score ≤8)...
March 2012: Journal of Trauma and Acute Care Surgery
Kenneth E Stewart, Linda D Cowan, David M Thompson, John C Sacra, Roxie Albrecht
OBJECTIVES: Helicopter emergency medical services (HEMS) transport of trauma patients has been used for decades. Its use, however, is still a subject of debate, including issues such as high costs, increasing numbers of crashes, and conflicting results regarding effectiveness in reducing mortality. The aim of this study was to examine whether mode of transport (HEMS vs. ground EMS) is independently associated with mortality among trauma patients transported directly from the scene of injury to definitive care...
November 2011: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jennifer Sundberg, Cristina Estrada, Cathy Jenkins, Jacqueline Ray, Thomas Abramo
OBJECTIVE: The objective of the study was to determine if hypothermia in pediatric trauma patients is associated with increased mortality. METHODS: We reviewed the charts of level 1 trauma patients aged 3 months to 17 years who presented between September 2006 and March 2008. We analyzed data for patients with temperatures recorded within 30 minutes of arrival to the pediatric emergency department. Logistic regression models were used to test for associations of hypothermia with death while adjusting for mode of transport, season of year, and presence of intracranial pathology as documented by an abnormal head computed tomographic scan...
November 2011: American Journal of Emergency Medicine
Alka B Patel, Nigel M Waters, William A Ghali
BACKGROUND: This study uses geographic information systems (GIS) as a tool to evaluate and visualize the general accessibility of areas within the province of Alberta (Canada) to cardiac catheterization facilities. Current American and European guidelines suggest performing catheterization within 90 minutes of the first medical contact. For this reason, this study evaluates the populated places that are within a 90 minute transfer time to a city with a catheterization facility. The three modes of transport considered in this study are ground ambulance, rotary wing air ambulance and fixed wing air ambulance...
2007: International Journal of Health Geographics
Michael T Cudnik, Craig D Newgard, Henry Wang, Christopher Bangs, Robert Herringtion
OBJECTIVES: Prior efforts have linked field endotracheal intubation (ETI) with increased out of hospital (OOH) time, but it is not clear if the additional time delay is due to the procedure, patient acuity, or transport distance. We sought to assess the difference in OOH time among trauma patients with and without OOH-ETI after accounting for distance and other clinical variables. METHODS: Retrospective cohort analysis of trauma patients 14 years or older transported by ground or air to one of two Level 1 trauma centers from January 2000 to December 2003...
April 2007: Prehospital Emergency Care
Christy L McCowan, Eric R Swanson, Frank Thomas, Stephen Hartsell, Todd L Allen, Diana L Handrahan, Kelli Kwok
OBJECTIVE: To examine the characteristics of pediatric patients (age =16 years) injured at winter resort scenes and transported by helicopter emergency medical services (HEMS) or ground EMS (GEMS) ambulance services to regional trauma centers. METHODS: Between 1997 and 2001, a total of 119 patients (GEMS = 69; HEMS = 50) were identified from trauma registries and HEMS transport records. Demographic data, initial vital signs, hospital interventions, and discharge status of the two groups were examined...
January 2006: Prehospital Emergency Care
Christy L McCowan, Frank Thomas, Eric R Swanson, Stephen Hartsell, Janet Cortez, Sue Day, Diana L Handrahan
INTRODUCTION: This study examined the epidemiology of winter resort injuries presenting to regional trauma centers by helicopter (HEMS) or ground (GEMS) ambulance. METHODS: Five hundred seventy-five patients (GEMS 289; HEMS 286) were identified from trauma registries and HEMS transport records. Demographic data, hospital interventions, and discharge status were examined. RESULTS: HEMS patients had a significantly lower Glasgow coma score (GCS) and trauma score (TS), longer intensive care unit (ICU) length of stay (LOS), and more deaths than did GEMS patients (P < 0...
January 2006: Air Medical Journal
Stephen H Thomas, Timothy H Harrison, Wende Reenstra Buras, Waleed Ahmed, Farah Cheema, Suzanne K Wedel
BACKGROUND: Despite many studies addressing potential impact of helicopter transport on trauma mortality, debate as to the efficacy of air transport continues. METHODS: This retrospective study combined trauma registry data from five urban Level I adult and pediatric centers. Logistic regression assessed effect of helicopter transport on mortality while adjusting for age, sex, transport year, receiving hospital, prehospital level of care (Advanced Life Support vs...
January 2002: Journal of Trauma
C K Stone, R C Hunt, J A Sousa, T W Whitley, S H Thomas
INTRODUCTION: The purpose of this study was to compare the outcome of interhospital transported cardiac patients for whom bias in selecting transport mode was removed due to helicopter unavailability. METHODS: Patients with the diagnosis of unstable angina or myocardial infarction who underwent transport by ground only because helicopter transport was not available, were compared to patients transported by helicopter. Patients were matched by gender and referring hospital...
May 1994: Air Medical Journal
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