Comparison of Helicopter Emergency Medical Services Transport Types and Delays on Patient Outcomes at Two Level I Trauma Centers

Tor-BN-Helicopter EMS Delays

Toronto (ED)

Background: Helicopter emergency   medical services (HEMS) have become an engrained component of trauma systems.   In Ontario, transportation for trauma patients is through one of three ways:   scene call, modified scene call, or interfacility transfer. We hypothesize that   differences exist between these types of transports in both patient   demographics and patient outcomes. This study compares the characteristics of   patients transported by each of these methods to two level 1 trauma centers   and assesses for any impact on morbidity or mortality. As a secondary outcome   reasons for delay were identified. 


Methods: A local trauma registry was used to identify and abstract data   for all patients transported to two trauma centers by HEMS over a 36-month   period. Further chart abstraction using the HEMS patient care reports was   done to identify causes of delay during HEMS transport. 


Results: During the study period HEMS transferred a   total of 911 patients of which 139 were scene calls, 333 were modified scene   calls and 439 were interfacility transfers. Scene calls had more patients   with an ISS of less than 15 and had more patients discharged home from the   ED. Modified scene calls had more patients with an ISS greater than 25. The   most common delays that were considered modifiable included the sending   physician doing a procedure, waiting to meet a land EMS crew, delays for   diagnostic imaging and confirming disposition or destination. 


Conclusions: Differences exist   between the types of transports done by HEMS for trauma patients. Many   identified reasons for delay to HEMS transport are modifiable and have   practical solutions. Future research should focus on solutions to identified   delays to HEMS transport. 


Authors: Brodie Nolan, Homer Tien, Bruce Sawadsky, Sandro Rizoli, Amanda McFarlan, Andrea Phillips, Alun Ackery

Preliminary data gathering/ baseline