Profile and outcomes of patients transported to an accident and emergency department by helicopter: prospective case series.

OBJECTIVES

To study the profile of airlifted patients and their outcomes after arrival at the hospital, and to evaluate the appropriateness of their prehospital care and the decision to use aeromedical evacuation.

DESIGN

Prospective case series.

SETTING

Accident and emergency department of a public hospital, Hong Kong.

PATIENTS

All patients transported to the department by a helicopter of the Government Flying Service from June 1998 through November 1998.

MAIN OUTCOME MEASURES

Demographic data, sources and locations of referral, clinical features, triage category, interventions used, and outcome.

RESULTS

A total of 186 patients were transferred by helicopter during the 6-month study period. The 101 patients who had been transferred from a rural hospital or clinic were older (mean age, 50 years versus 35 years), comprised more females (55% versus 26%), had a higher overall mortality rate (19.8% versus 3.6%), and had a higher hospital admission rate (91.1% versus 37.6%) than the 85 patients who had been airlifted from the scene of an emergency. Neurological disorders were the most common presentation among interfacility transfers (21.8%). Among the 85 scene transfers, limb injuries (32.1%) and heat illnesses (24.4%) were the most common reasons for helicopter transport. Most interfacility transfers were appropriate, but 34.1% of patients who had been transferred from the scene of the emergency were later discharged and 21.1% refused consultation.

CONCLUSIONS

Scene and interfacility transfers by helicopter have different patient profiles, and a substantial proportion of scene transfers may be inappropriate. Guidelines such as field triage and helicopter dispatch criteria need to be established.