Helicopter EMS (HEMS) has rapidly grown over the past 30 years. HEMS is frequently used to transport trauma patients from the scene of a crash. The question is: for which trauma patients is HEMS most useful?
A recent article published in the Journal of the American Medical Association, based upon data from the National Trauma Data Bank (NTDB), looked at injured patients transported to a trauma center by helicopter versus ground ambulance. It showed that, after controlling for multiple known confounders, more severely injured patients had better outcomes when transported by helicopter than when transported by ground ambulances. Another recent article in the Journal of Trauma and Acute Care Surgery, again based upon the NTDB further showed that HEMS survival benefit seems to limited to individuals with physiologic instability.
Bottom Line:
Transport of severely injured trauma patients by helicopter versus ground from the scene of injury to a trauma center improved patient outcomes and decreased mortality. Transportation of stable, less injured patients by helicopter may actually worsen outcomes.
University of Maryland Section of Global Emergency Health
Author: Jon Mark Hirshon
References
Galvagno SM,Jr, Haut ER, Zafar SN, et al. Association between helicopter vs ground emergency medical services and survival for adults with major trauma. JAMA 2012;307:1602-10.
Ryb GE, Dischinger P, Cooper C, Kufera JA. Does helicopter transport improve outcomes independently of emergency medical system time? J Trauma Acute Care Surg. 2013 Jan;74(1):149-54.
