Article Text

other Versions

PDF
Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence
  1. Daniel P Butler,
  2. Imran Anwar,
  3. Keith Willett
  1. Department of Orthopaedic Trauma Surgery, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford, UK
  1. Correspondence to Dr Daniel P Butler, Academic Foundation Trainee, Department of Orthopaedic Trauma Surgery, University of Oxford, Kadoorie Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK; dan.butler{at}doctors.org.uk

Abstract

Background and aim Prehospital care of trauma patients is a matter of great debate. The optimal transport method remains undecided, with conflicting data comparing helicopter and ground emergency medical transfer. This study systematically reviews the evidence comparing helicopter and ground transfer of trauma patients from the scene of injury.

Methods A systematic literature review of all population-based studies evaluating the impact on mortality of helicopter transfer of trauma patients from the scene of injury. We searched MEDLINE, CINAHL and EMBASE from January 1980 to December 2008 and selected and reviewed potentially relevant studies.

Results A search of the literature revealed 23 eligible studies. 14 of these studies demonstrated a significant improvement in trauma patient mortality when transported by helicopter from the scene. 5 of the 23 studies were of level II evidence with the remainder being of level III evidence. Data were then entered into an evidence table and reference made to transport staffing, intubation rate, time at scene and time/distance of transfer.

Conclusions The role and structure of HEMS in a modern trauma service is a debate that is likely to continue. Prehospital care design should be specific to critical incident frequency, geographical arrangements of hospital facilities and travel times within each trauma network. It is also important to consider the benefits and capabilities of the emergency medical team separately from the transport method being considered. An effective helicopter EMS will ultimately depend on effective operating procedures and tasking protocols, clinical governance, and auditing of the helicopter EMS activity.

  • Emergency care systems
  • helicopter retrieval
  • prehospital care, trauma

Statistics from Altmetric.com

Footnotes

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

  • Primary survey
    Kevin Mackway-Jones