Air medical transport of the injured patient: Scene versus referring hospital

Aeromedical Retrieval for Critical Clinical Conditions: 12 Years of Experience with the Royal Flying Doctor Service, Queensland, Australia

“…The RFDS is an important part of the trauma system across Australia and, as demonstrated in this study, trauma was the most common clinical diagnosis and patients were mostly transported direct to major tertiary hospitals (28). This is consistent with US data demonstrating direct transfer to a major center with appropriate facilities for definitive care results in improved outcomes when compared with an intermediate stop at a less equipped hospital (29). RFDS (Qld) is able to achieve this by having aircraft with the capacity to land on remote airfields with limited facilities and fly the extreme distances required to reach cities with major health facilities, with appropriate flight staff and equipment to provide intensive-care-level treatment while en route.…”

Impact of Interhospital Transfer on Outcomes for Trauma Patients: A Systematic Review

“…Eight studies were conducted in a rural setting. 20,35,[37][38][39]42,46,47 The remaining studies were conducted in urban or mixed urban/nonurban settings. The patient populations were restricted to blunt or penetrating trauma, 19,23,25,34 orthopedic, 43 blunt pancreatic, 42 and brain and head injury, 18,21,22,27,35,44,45,51 respectively, in 14 studies.…”

“…18 This was consistent with the subgroup analysis performed by Garwe et al, 46 who found higher 2-week mortality in transfer patients (hazard ratio, 2.71; 95% CI, 1.31-5.6). Of the seven studies conducted in predominantly rural settings, 20,35,[37][38][39]42,46 only one demonstrated mortality difference between transfer and direct patients. 24 These authors found a threefold higher adjusted incidence rate of death in transfer patients compared with direct admissions.…”

The Impact of Aeromedical Response to Patients With Moderate to Severe Traumatic Brain Injury

“…[1][2][3][4] Foremost among these factors include the avoidance of secondary insults, such as hypoxia and hypotension, and the identification of potential traumatic brain injury and subsequent triage to a facility capable of definitive care, [5][6][7][8][9][10] which has led to the development of emergency medical services (EMS) systems that provide a rapid response to major trauma victims and can offer a variety of therapeutic interventions, such as endotracheal intubation and intravenous fluids, as well as rapid transport to a designated receiving facility. 11,12 Helicopters are used in many systems to respond to major trauma victims, with 3 theoretical therapeutic advantages: (1) rapid transport to a designated receiving facility when ground transport is unavailable or would lead to inordinate delays, (2) response by advanced practitioners with an expanded scope of practice to optimize early care, and (3) response by crews with greater experience managing critically injured patients.…”