E. C. Gray1, M. A. Quinn1, S. Brown1, J. B. Yarger1, J. B. Burns1 1East Tennesse State University,Quillen College Of Medicine Department Of Surgery,Johnson City, TN, USA
Introduction: Helicopter Emergency Medical Services (HEMS) allow rapid transport of trauma patients over long distances which is beneficial in a rural trauma setting. However this rapid transit comes with an increase in monetary cost and risk to both crew and patient. We compared pediatric and adult trauma patients who were transported via HEMS to determine if pediatric patients would have a lower Injury Severity Score (ISS) and be more likely to be discharged home from the emergency department (ED).
Methods: Retrospective data was collected from January 1, 2010 to December 31, 2016 from the trauma registry data for an Appalachian Level 1 adult and pediatric general referral center. All trauma patients arriving via helicopter were included. A chi-square test was used to compare ISS for pediatric and adult patients. Patient disposition was also compared to explore rate of discharge from the ED. Pediatric patients were considered those younger than 16 years of age.
Results: Of 1,604 trauma patients transported by HEMS, 9.8% were pediatric patients and 90.2% were adults. A statistically higher percent of pediatric patients had an ISS of 0-15 versus adults (72.1% versus 59.4% p=0.002) and fewer pediatric patients had an ISS of 16-75 compared to adults (27.9% versus 40.6% p=0.002). Additionally, pediatric patients were more likely to be discharged to home from the ED (33.1% versus 23.2%)
Conclusion: Pediatric patients transported via HEMS were significantly more likely to have a lower ISS and to be discharged to home. Currently there is no standardized system to triage pediatric patients to HEMS versus ground transport. Based on the data it would appear that EMS providers may benefit from standardization to reduce cost and risk associated with HEMS usage.
