Helicopter transportation of burn patients
Introduction
Since its introduction as an ambulance during the Korean War, helicopter flight to burn centers has become a common occurrence. Helicopter delivery of burn patients accounts for an ever-increasing percentage of our admissions. On an anecdotal basis we have noted flights from nearby and distant hospitals that transferred patients with minimal burns. On occasion we have had patient transfers from nearby hospitals delayed many hours while waiting for weather conditions to clear so that helicopter transport of a patient could be accomplished instead of using ground ambulance transfer. In view of the great expense, and potential risk to patient and crew, we believe that understanding of the factors that influence the choice of helicopter transport of burn patients can help bring a more rational use of this service.
Section snippets
Study design
Records of all burn patients transported to our burn center in the past 15-month-period were reviewed. Burn surface area, history of smoke inhalation, age, and method and distance of transportation were analyzed in each case. Statistical analysis was done using GraphPad InStat version 3.01 for Windows 95/NT, GraphPad Software, San Diego, California, USA, www.graphpad.com. Unpaired, two-tailed t-test or Fisher exact test were used in all cases.
Results
There were 437 patients transported to our burn center during this time period. Of these, 339 were transported by ground and another 98 by helicopter. Of the air transport patients, 18 came from within a 25-mile-radius, and 80 were flown further than 25 miles. They ranged in age from 3 months to 97 years with a mean age of 33.4±20.7 (S.D.) years in the ground transports, and 38.7±16.8 and 39.2±23.3 years in helicopter transports (less than and greater than 25 miles flown, respectively), (mean
Discussion
Outcome studies comparing helicopter and ground ambulance transported patients have yielded conflicting results [1], [2], [3]. Brathwaite et al. [4] suggested reappraisal of helicopter transport when Advanced Life Support personnel are available at the trauma scene. No clinical benefit of helicopter transport of acute burn patients to a burn center was found by Baack et al. [5] Our studied group of patients contained many who could have been safely, and speedily, transferred to our burn center
Summary
We believe that many burn patients transported to our burn center by helicopter could be safely transported in a ground ambulance staffed by trained para-medical crew. The overutilization of air transport for most burn patients is multifactorial and is minimally based on clinical findings. A single regional helicopter service that is governed by a board of representatives of trauma, burn, and tertiary referral centers would allow for the creation of protocols for air transport that could be
Acknowledgements
We would like to thank P.J. Manni and Devora E. Hathaway, for their assistance in the preparation of this paper.
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