Background: For about 25 000 Ontarians living in remote northern First Nations communities, seeing a   doctor in an emergency department requires flying in an airplane or   helicopter. This study describes the demographic and epidemiologic   characteristics of patients transported from these communities to access   hospital-based emergency medical care.

Methods: In this cross-sectional descriptive study, we examined primary medical data on   patient transportation from Ornge, the provincial medical air ambulance   service provider, for 26 remote Nishnawbe Aski Nation communities in northern   Ontario from 2012 to 2016. We described these transports using univariate   descriptive statistics.

Results: Over the 5-year study period, 10 538 patients (mean 2107.6 per year) were transported   by Ornge from the 26 communities. Transport incidence ranged from 9.2 to 9.5   per 100 on-reserve population per year. Women aged 65 years or more had the   highest transport incidence (25.9 per 100). Girls aged 5–9 years had the   lowest mean incidence (2.1 per 100). Gastrointestinal issues accounted for   13.3% of transfers. Neurologic issues, respiratory issues and trauma each   accounted for about 11% of transfers, and cardiac issues for 9.6%. Patients   with obstetric issues accounted for 7.6% of transfers per year, and   toxicologic emergencies for 7.5%.

Interpretation: This study provides the epidemiologic foundation to improve emergency care and   emergency transport from remote First Nation communities in Ontario.

Authors: David VanderBurgh, David W. Savage, Sacha Dubois, Natalie Binguis, Sadie Maxwell, Natalie Bocking, Terri Farrell, Homer Tien, Stephen D Ritchie, Aaron Orkin