Helicopter Emergency Medical Services (HEMS): Impact on On-Scene Times
Patients treated by a combination of physician-staffed helicopter emergency medical services (HEMS) and nurse-staffed emergency medical services (EMS) with prehospital on-scene times (OST) were compared with patients treated only by EMS with OST in regard to OST in this study. Investigating the relationship between mortality and OST length was a secondary aim. Included in the study were all trauma patients at a Level I trauma center priority 1 emergency room between January 2002 and 2004. Prehospital and hospital data were entered into the trauma registry to determine OST and outcome. Linear regression analysis was used to compare OSTs for combined EMS/HEMS and EMS only-treated patients. Mortality rates were compared through logistic regression analysis. In the analysis, 1,457 trauma patients were included, of which combined EMS/HEMS was given to 260 and EMS only assistance was given to 1,197. HEMS patients had higher Injury Severity Scores (24 vs. 9; p < 0.001) and longer mean OSTs (35.4 vs. 24.6 minutes; p < 0.001). There was a 9 minute difference (p < 0.001) in OSTs between the groups after patient and trauma characteristics, like daytime/night-time and mechanism of trauma, Injury Severity Scores, age, and Revised Trauma Score. Increasing OST by 10 minutes (OR, 1.2; p < 0.001) resulted in a higher uncorrected chance of dying, as shown through logistic regression analyses. Patient and trauma characteristics (adjusted OR, 1.0; p = 0.89) explained this apparent OST effect on mortality. Longer OST is associated with, at an injury scene, combined EMS/HEMS assistance. No longer OST influence on mortality could be demonstrated when corrected for patient characteristics and injury severity.
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Availability:
- Find a library where document is available. Order URL: http://worldcat.org/issn/00225282
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Authors:
- Ringburg, Akkie N
- Spanjersberg, Willem R
- Frankema, Sander P G
- Steyerberg, Ewout W
- Patka, Peter
- Schipper, Inger B
- Publication Date: 2007-8
Language
- English
Media Info
- Media Type: Print
- Features: References; Tables;
- Pagination: pp 258-262
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Serial:
- Journal of Trauma, Injury, Infection and Critical Care
- Volume: 63
- Issue Number: 2
- Publisher: Lippincott Williams & Wilkins
- ISSN: 0022-5282
Subject/Index Terms
- TRT Terms: Emergency medical services; Fatalities; Helicopters; Injuries; Linear regression analysis; Logistic regression analysis; Patients; Time
- Identifier Terms: Injury Severity Score
- Uncontrolled Terms: Characteristics; Mortality
- Subject Areas: Aviation; Highways; Safety and Human Factors; I83: Accidents and the Human Factor;
Filing Info
- Accession Number: 01055918
- Record Type: Publication
- Files: TRIS
- Created Date: Aug 28 2007 1:57PM