Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Center for Pediatric Trauma Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
J Pediatr Surg. 2022 Nov;57(11):637-643. doi: 10.1016/j.jpedsurg.2022.05.010. Epub 2022 May 16.
Helicopter emergency medical services (HEMS) are intended to expedite care to definitive management. Studies are inconclusive in demonstrating appropriate use. We aimed to examine emergent interventions after interfacility helicopter transport (IHT) to our pediatric trauma center.
Trauma patients 0-18 years undergoing IHT or interfacility ground transport (IGT) to our institution from January 2011-December 2020 were studied. We evaluated the rate of IHT patients undergoing emergent (1 h), urgent (6 h), and semi urgent (48 h) operating room (OR) intervention compared to IGT as a measure of appropriate transport.
Inclusion was met by 1003 IHT and 7829 IGT patients. OR intervention was required in 29.6% of IHT patients, emergent in 1.3%, urgent in 12.6%, and semi urgent in 10.6%. Overall, IHT patients had higher mean injury severity score (ISS; IHT:14.5; SD:11.0 vs. IGT:6.0; SD:5.0; p < 0.01) and lower GCS (IHT:12.0; SD:4.9 vs. IGT:14.8; SD:1.4; p < 0.01), though over triage (ISS ≤ 15) occurred in 67.9% of patients.
More interfacility helicopter transport patients underwent emergent and urgent procedures compared to interfacility ground transport patients; however, emergent intervention was not required in 98.7% of interfacility helicopter transport patients and over two thirds had ISS ≤ 15, possibly suggesting overutilization of interfacility helicopter transport for pediatric trauma patients at our center.
Level III.
直升机紧急医疗服务（HEMS）旨在加快对明确治疗的护理。研究结果尚无定论，无法证明其使用的合理性。我们旨在检查送往我们儿科创伤中心的患者在接受院际间直升机转运（IHT）后的紧急干预措施。
研究对象为 2011 年 1 月至 2020 年 12 月期间，在我院接受 IHT 或院际间地面转运（IGT）的 0-18 岁创伤患者。我们评估了与 IGT 相比，IHT 患者接受紧急（1 小时内）、紧急（6 小时内）和半紧急（48 小时内）手术室（OR）干预的比率，以作为适当转运的衡量标准。
共纳入 1003 例 IHT 和 7829 例 IGT 患者。29.6%的 IHT 患者需要进行 OR 干预，其中 1.3%为紧急干预，12.6%为紧急干预，10.6%为半紧急干预。总体而言，IHT 患者的平均损伤严重程度评分（ISS；IHT：14.5，标准差：11.0 与 IGT：6.0，标准差：5.0；p<0.01）和格拉斯哥昏迷评分（GCS；IHT：12.0，标准差：4.9 与 IGT：14.8，标准差：1.4；p<0.01）更高，但超过分诊标准（ISS≤15）的患者占 67.9%。
与院际间地面转运患者相比，更多的院际间直升机转运患者接受了紧急和紧急手术；然而，在 98.7%的院际间直升机转运患者中并未需要紧急干预，超过三分之二的患者 ISS≤15，这可能表明在我们中心，对儿科创伤患者过度使用了院际间直升机转运。
III 级。
