Air medical transport for the trauma patient requiring cardiopulmonary resuscitation: A 10-year experience

Falcone, Robert E.; Herron, Holly; Childress, Susan; Lacey, Patty; Scheiderer, Gwen

doi:10.1016/1067-991x(95)90002-0

Cited by 12 publications

(3 citation statements)

References 19 publications

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“…Our data lack activation times, response times, and on-scene times and thus cannot be compared. Studies conducted by Delgado et al [ 17 ] and Falcone et al [ 18 ] compared the effectiveness of HEMS with ground transport system for the transportation of trauma patients in the USA and failed to show benefit of HEMS for reducing mortality. Similar results have been shown by Olson et al [ 6 ] in stroke patients requiring fibrinolytic therapy.…”

Section: Discussionmentioning

confidence: 99%

A retrospective comparison of helicopter transport versus ground transport in patients with severe sepsis and septic shock

et al. 2016

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BackgroundHelicopter emergency medical services (HEMS) extend the reach of a tertiary care center significantly. However, its role in septic patients is unclear. Our study was performed to clarify the role of HEMS in severe sepsis and septic shock.MethodsThis is a single-center retrospective cohort study. This study was performed at Mayo Clinic, Rochester, MN, in years 2007–2009. This study included a total of 181 consecutive adult patients admitted to the medical intensive care unit meeting criteria for severe sepsis or septic shock within 24 h of admission and transported from an acute care facility by a helicopter or ground ambulance. The primary predictive variable was the mode of transport. Multiple demographic, clinical, and treatment variables were collected and analyzed with univariate analysis followed by multivariate analysis.ResultsThe patients transported by HEMS had a significantly faster median transport time (1.3 versus 1.7 h, p < 0.01), faster time to meeting criteria for severe sepsis or septic shock (1.2 versus 2.9 h, p < 0.01), a higher SOFA score (9 versus 7, p < 0.01), higher incidence of acute respiratory distress syndrome (38 versus 18 %, p = 0.013), higher need for invasive mechanical ventilation (60 versus 41 % p = 0.014), higher ICU mortality (13.3 versus 4.1 %, p = 0.024), and an increased hospital mortality (17 versus 30 %, p = 0.04) when compared to those transported by ground. Distance traveled was not an independent predictor of hospital mortality on multivariate analysis.ConclusionsHEMS transport is associated with faster transport time, carries sicker patients, and is associated with higher hospital mortality compared with ground ambulance services for patients with severe sepsis or septic shock.

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Section: Discussionmentioning

confidence: 99%

A retrospective comparison of helicopter transport versus ground transport in patients with severe sepsis and septic shock

et al. 2016

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“…Patients in extremis without access to prehospital critical care, should however be transported to the nearest emergency department as safely and as rapidly as possible-this may well be most appropriately achieved by road particularly if transport times are less than 45 minutes, accepting that many such patients may not have survivable injuries. 29 30 Patients in traumatic arrest should not be transported by helicopter to hospital as there is considerable experience demonstrating no survival benefit in this scenario, 31 and unrestrained flight crew may be exposed to unacceptable risk.…”

Section: Adverse Clinical Signsmentioning

confidence: 99%

Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom: an algorithm

Black

Ward²,

Lockey³

2004

Emergency Medicine Journal

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“…Another important factor in the inherently provisional nature of data analysis in this context is the potential for future improvement in patient outcomes. For example, the three studies claiming futility of CPR for traumatic cardiac arrest were published in 1993, 1995 and 2004 based on mortality rates of 100% [24][25][26] , whereas two of three studies refuting the claim that this treatment is futile, were published in 2006 and one in 2003 21,27,28 . Mortality rates in the latter three articles were 44% to 94%.…”

Section: Discussionmentioning

confidence: 99%

The Empirical Basis for Determinations of Medical Futility

et al. 2010

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BACKGROUND: Decisions to limit treatment in critically ill patients often rely on publications that make claims of futility based on outcome data. Our objective was to systematically review the criteria for futility and the strength of empirical evidence across clinical studies that purport to support or refute claims of futility. METHODS: The MEDLINE database was searched for relevant articles published between1980 and 2008. Selected studies reported original outcome data in critically ill or cardiac arrest patients and claimed that these data can support or refute decisions to limit treatment in comparable patients. Two authors independently abstracted data on patient characteristics, intervention, outcomes, cost, and design. RESULTS: Forty seven studies supporting a claim of futility and 45 refuting it were reviewed. Median point estimate for adverse outcome in studies supporting claims of futility was 100% (range 75% to 100%); median lower 95% confidence limit was 91% (range 48% to 99%). Explicit thresholds for futility were missing in 88% of articles. The original criteria for quantitative futility were fulfilled by only 28% of data, and almost exclusively in studies of cardiopulmonary resuscitation (CPR) for cardiac arrest. Substantial statistical overlap was observed between data brought in support of futility claims and data brought to refute them. CONCLUSIONS: Most studies that purport to guide determinations of futility are based on insufficient data to provide statistical confidence for clinical decisionmaking. They usually lack explicit a priori thresholds for determination of futility. Many studies draw disparate conclusions based on statistically similar data. In most circumstances these problems preclude confident determinations of futility.

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Air medical transport for the trauma patient requiring cardiopulmonary resuscitation: A 10-year experience

Cited by 12 publications

References 19 publications

A retrospective comparison of helicopter transport versus ground transport in patients with severe sepsis and septic shock

A retrospective comparison of helicopter transport versus ground transport in patients with severe sepsis and septic shock

Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom: an algorithm

The Empirical Basis for Determinations of Medical Futility

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