Southeast Alaska to Seattle emergency medical air transports: demographics, stabilization, and outcomes.

Most rural EMS aeromedical transport studies have been based on distances of less than 100 miles. No current published studies exist evaluating long-distance transports. A retrospective chart review was conducted of all patients transported from southeast Alaska to Seattle, Washington, by an intensive care air ambulance over a five-year period (1982-1986). During the study period, 442 patients were transported an average one-way distance of 703 +/- 58.9 miles. Of these, 134 had a diagnosis of major or multiple trauma and were the focus of the study. Patient demographics and medical stabilization by Alaskan physicians, the flight team, and the receiving hospital were analyzed. Injury severity and outcomes also were evaluated. Of the study group, 31% required air transport within Alaska before being seen by a physician. The flight team provided major stabilization for 11% of the trauma victims, minor stabilization for 42%, and no further stabilization for 47%. Patient flights were categorized using previously published criteria as "essential" to survival in 27% of the cases, "helpful" in 55%, and "noncontributory" in 18%. This study presents a profile of patients injured in remote areas who require stabilization by rural, often nonsurgical physicians and face long-distance transfers before reaching definitive care. Health-care systems in sparsely populated areas may use this study as a reference for comparing trauma outcomes and quality of care in long-distance air transport.