scholarly journals The contribution of helicopter emergency medical services in the pre-hospital care of penetrating torso injuries in a semi-rural setting

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
M. Gavrilovski ◽  
J. E. Griggs ◽  
E. ter Avest ◽  
R. M. Lyon ◽  
Keyword(s):  
Emergency Medical Services ◽  
Rural Areas ◽  
Penetrating Trauma ◽  
Trauma Centre ◽  
Rural Setting ◽  
Medical Services ◽  
Hospital Treatment ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical ◽  
Major Trauma Centre

Abstract Background Although the merit of pre-hospital critical care teams such as Helicopter Emergency Medical Services (HEMS) has been universally recognized for patients with penetrating torso injuries who present with unstable physiology, the potential merit in patients initially presenting with stable physiology is largely undetermined. The ability to predict the required pre-hospital interventions patients may have important implications for HEMS tasking, especially when transport times to definitive care are prolonged. Methods We performed a retrospective cohort study of patients who sustained a penetrating torso injury and were attended by the Air Ambulance Kent Surrey Sussex (AAKSS) over a 6-year period. Primary outcome was defined as the percentage of patients with penetrating torso injuries requiring HEMS-specific interventions anytime between HEMS arrival and arrival at hospital. Secondary outcomes were the association of individual patient- and injury characteristics with the requirement for HEMS interventions. Results During the study period 363 patients met inclusion criteria. 90% of patients were male with a median age of 30 years. 99% of penetrating trauma incident occurred more than 10-min drive from a Major Trauma Centre (MTC). Presenting GCS was > 13 in 83% of patients. Significant hemodynamic- or ventilatory compromise was present in more than 25% of the patients. Traumatic cardiac arrest was present in 34 patients (9.4%), profound hypotension with SBP < 80 mmHg in 30 (8.3%) and oxygen saturations < 92% in 30 (8.3%). A total of 121 HEMS-specific interventions were performed. Although HEMS-specific interventions were associated with presenting physiology (TCA OR 1.75 [1.41–2.16], SBP < 80 mmHg (OR 1.40 [1.18–1.67] and SpO2 < 92% (OR 1.39 [1.17–1.65], a minority of the patients presented initially with stable physiology but deteriorated on route to hospital and required HEMS interventions (n = 9, 3.3%). Conclusion HEMS teams provide potentially important contribution to the pre-hospital treatment of patients with penetrating torso injuries in rural and semi-rural areas, especially when they present with unstable physiology. A certain degree of over-triage is inevitable in these patients, as it is hard to predict which patients will deteriorate on route to hospital and will need HEMS interventions. The results of this study showing a potentially predictable geographical dispersion of penetrating trauma could inform multi-agency knife crime prevention strategy.

scholarly journals P095: Who, what, where: a critical assessment of helicopter emergency medical services transport and transfer times on patient outcomes at two level 1 trauma centres

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S110-S110
Author(s):  
B. Nolan ◽  
A. Ackery ◽  
H. Tien ◽  
B. Sawadsky ◽  
S. Rizoli ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Emergency Medical Services ◽  
Trauma Centre ◽  
Medical Services ◽  
Trauma Patients ◽  
Helicopter Emergency Medical Services ◽  
Trauma Centres ◽  
Emergency Medical ◽  
Level 1 ◽  
Mode Of Transport

Introduction: Helicopter emergency medical services (HEMS) have become an engrained component of trauma systems to expedite transportation to a trauma centre. Ornge is a provincially run, paramedic-staffed HEMS that is responsible for all air ambulance service within Ontario, Canada. They provide transportation for trauma patients through one of three ways: scene call, modified scene call or interfacility transfer. In this study we report the characteristics of patients transported by each of these methods to two level 1 trauma centres and assess for any impact on morbidity or mortality. Methods: A local trauma registry was used to identify all patients transported to our two trauma centres by HEMS over a 36-month period. Data surrounding patient demographic, arrival characteristics, transport times and in-hospital course were abstracted from the registry. Statistical analysis will be used to compare methods of transport and characterize any association between mode of transport and mortality. Results: From January 1st, 2012 to December 31st, 2014 HEMS transferred a total of 911 patients to our trauma centers with an overall mortality rate of 11%. Of these patients 139 were scene calls with a mortality rate of 8%, 333 were modified scene calls with a mortality rate of 14% and 439 were interfacility transfers with a mortality rate of 10%. Conclusion: Identifying any association between the type of HEMS transport and morbidity and mortality, we may be able to predict those that need more urgent transfer to a trauma centre and find ways to decrease our overall pre-trauma center time.

scholarly journals Development of unmanned aerial vehicle (UAV) networks delivering early defibrillation for out-of-hospital cardiac arrests (OHCA) in areas lacking timely access to emergency medical services (EMS) in Germany: a comparative economic study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043791
Author(s):  
Jan Bauer ◽  
Dieter Moormann ◽  
Reinhard Strametz ◽  
David A Groneberg
Keyword(s):  
Cost Effectiveness ◽  
Emergency Medical Services ◽  
Rural Areas ◽  
Medical Services ◽  
Secondary Outcome ◽  
Annual Average ◽  
Emergency Medical ◽  
Life Years ◽  
Timely Access ◽  
The Cost

ObjectivesThis study wants to assess the cost-effectiveness of unmanned aerial vehicles (UAV) equipped with automated external defibrillators (AED) in out-of-hospital cardiac arrests (OHCA). Especially in rural areas with longer response times of emergency medical services (EMS) early lay defibrillation could lead to a significant higher survival in OHCA.Participants3296 emergency medical stations in Germany.SettingRural areas in Germany.Primary and secondary outcome measuresThree UAV networks providing 80%, 90% or 100% coverage for rural areas lacking timely access to EMS (ie, time-to-defibrillation: >10 min) were developed using a location allocation analysis. For each UAV network, primary outcome was the cost-effectiveness using the incremental cost-effectiveness ratio (ICER) calculated by the ratio of financial costs to additional life years gained compared with current EMS.ResultsCurrent EMS with 3926 emergency stations was able to gain 1224 life years on annual average in the study area. The UAV network providing 100% coverage consisted of 1933 UAV with average annual costs of €43.5 million and 1845 additional life years gained on annual average (ICER: €23 568). The UAV network providing 90% coverage consisted of 1074 UAV with average annual costs of €24.2 million and 1661 additional life years gained on annual average (ICER: €14 548). The UAV network providing 80% coverage consisted of 798 UAV with average annual costs of €18.0 million and 1477 additional life years gained on annual average (ICER: €12 158).ConclusionThese results reveal the relevant life-saving potential of all modelled UAV networks. Furthermore, all analysed UAV networks could be deemed cost-effective. However, real-life applications are needed to validate the findings.

A61 Effect of Helicopter Emergency Medical Services (HEMS) care in a cohort of 1,073 polytraumatized patients

Injury ◽  
2011 ◽  
Vol 42 ◽  
pp. S17
Author(s):  
G.F. Giannakopoulos ◽  
A. Noor ◽  
M.N. Kolodzinskyi ◽  
H.M.T. Christiaans ◽  
C. Boer ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Medical Services ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical

A Descriptive Analysis of Traction Splint Utilization and IV Analgesia by Emergency Medical Services

2017 ◽  
Vol 32 (6) ◽  
pp. 631-635 ◽  
Author(s):  
Joshua Nackenson ◽  
Amado A. Baez ◽  
Jonathan P. Meizoso
Keyword(s):  
Emergency Medical Services ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Femur Fracture ◽  
Descriptive Analysis ◽  
Penetrating Trauma ◽  
Physical Exam ◽  
Medical Services ◽  
Prehospital Treatment ◽  
Emergency Medical

AbstractStudy ObjectivesTraction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA).MethodsThis is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013. The EMS patient care reports were assessed for physical exam findings and treatment modality. Data were analyzed descriptively and statistical differences were assessed using odds ratios and Z-score with significance set at P≤.05.ResultsThere were 170 patients studied in the cohort. The most common physical exam finding was a deformity +/- shortening and rotation in 136 patients (80.0%), followed by gunshot wound (GSW) in 22 patients (13.0%), pain or tenderness in four patients (2.4%), and no findings consistent with femur fracture in three patients (1.7%). The population was dichotomized between trauma type: blunt versus penetrating. Of 134 blunt trauma patients, 50 (37.0%) were immobilized in traction, and of the 36 penetrating trauma victims, one (2.7%) was immobilized in traction. Statistically significant differences were found in the application of a TS in blunt trauma when compared to penetrating trauma (OR=20.83; 95% CI, 2.77-156.8; P <.001). Intravenous analgesia was administered to treat pain in only 35 (22.0%) of the patients who had obtainable IV access. Of these patients, victims of blunt trauma were more likely to receive IV analgesia (OR=6.23; 95% CI, 1.42-27.41; P=.0067).ConclusionAlthough signs of femur fracture are recognized in the majority of cases of midshaft femur fracture, only 30% of patients were immobilized using a TS. Statistically significant differences were found in the utilization of a TS and IV analgesia administration in the setting of blunt trauma when compared to penetrating trauma.NackensonJ, BaezAA, MeizosoJP. A descriptive analysis of traction splint utilization and IV analgesia by Emergency Medical Services.Prehosp Disaster Med. 2017;32(6):631–635.

scholarly journals Reporting Helicopter Emergency Medical Services in Major Incidents: A Delphi Study

2016 ◽  
Vol 35 (6) ◽  
pp. 348-351 ◽  
Author(s):  
Sabina Fattah ◽  
Anne Siri Johnsen ◽  
Stephen J.M. Sollid ◽  
Torben Wisborg ◽  
Marius Rehn ◽  
...  
Keyword(s):  
Emergency Medical Services ◽  
Delphi Study ◽  
Medical Services ◽  
Helicopter Emergency Medical Services ◽  
Emergency Medical ◽  
Major Incidents
Sign in / Sign up

Export Citation Format

Share Document