Hakakian Daniel, Kong Karen, Bogdanovski Dorian Atanas, Benvenuto Andrew, DiFazio Louis Thomas, Durling-Grover Renay, Rolandelli Rolando Hector, Nemeth Zoltan H
Department of Surgery, Morristown Medical Center, Morristown, NJ.
Department of Surgery, Morristown Medical Center, Morristown, NJ; Department of Anesthesiology, Columbia University Medical Center, NY, NY; Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Air Med J. 2019 Mar-Apr;38(2):95-99. doi: 10.1016/j.amj.2018.11.013. Epub 2019 Jan 16.
Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome.
Morristown Medical Center (MMC), Morristown, NJ METHODS: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed.
22% of admissions were HEMS and 78% were GEMS. HEMS patients had higher Injury Severity Scores (ISS) (p<0.001); however, mortality and length of stay were not statistically different. The percentage of pediatric patients transported by HEMS that were discharged home after emergency department evaluation was greater than the older populations (p<0.001). Older age and higher ISS had the largest impact on mortality (p<0.001).
We believe our current use of HEMS is adequate since patient outcomes between HEMS and GEMS was similar, even though HEMS patients have higher ISS. However, helicopter use in the pediatric population was over-utilized, possibly due to the scarcity of hospitals capable of managing pediatric traumas. Implementation of the Air Medical Prehospital Triage scoring system may also help correct for these unnecessary HEMS transports.
通过地面紧急医疗服务（GEMS）或直升机紧急医疗服务（HEMS）将患者高效转运至创伤中心对于提供最佳治疗至关重要。我们在人口统计学、损伤情况、现场位置和治疗结果方面调查了两种转运模式之间的差异。
新泽西州莫里斯敦的莫里斯敦医疗中心（MMC）
对2016年通过高级生命支持（ALS）送至一级创伤中心MMC的所有903例创伤入院患者进行回顾性分析。
22%的入院患者通过直升机紧急医疗服务转运，78%通过地面紧急医疗服务转运。直升机紧急医疗服务转运的患者损伤严重程度评分（ISS）更高（p<0.001）；然而，死亡率和住院时间在统计学上并无差异。经急诊科评估后通过直升机紧急医疗服务转运出院回家的儿科患者比例高于老年人群（p<0.001）。年龄较大和损伤严重程度评分较高对死亡率影响最大（p<0.001）。
我们认为，目前直升机紧急医疗服务的使用是恰当的，因为尽管直升机紧急医疗服务转运的患者损伤严重程度评分更高，但两种转运方式的患者治疗结果相似。然而，直升机在儿科患者中的使用存在过度情况，可能是由于能够处理儿科创伤的医院较少。实施空中医疗院前分诊评分系统也可能有助于纠正这些不必要的直升机紧急医疗服务转运。
