Helicopter transport of injured children: system effectiveness and triage criteria

Moront, Matthew; Gotschall, Catherine S.; Eichelberger, Martin R.

doi:10.1016/s0022-3468(96)90114-1

Cited by 90 publications

(54 citation statements)

References 17 publications

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“…38 The alternate harm, of overtriaging patients to high-level trauma care (and in many cases, helicopter transport), is primarily one of unnecessary resource utilization. 39 In addition, some data indicate that despite their broad inclusiveness, previous iterations of the CDC trauma triage criteria might actually reduce overtriage rates. 40 The panel considered patients' likely preferences regarding risk of death or major disability versus risk of potential resource overutilization.…”

Section: Use Of the Cdc 2011 Guidelines For The Field Triage Of Injurmentioning

confidence: 99%

“…38 Moront et al determined that in pediatric trauma, the combination of GCS < 12 and HR > 160 yielded a 99% sensitivity and 90% specificity for major trauma, although there were limitations in the study. 39 Stewart et al determined that the mortality benefit of HEMS was minimal in patients with normal vital signs or in whom the Revised Trauma Score was less than 3. 49 The issue of HEMS activation is perhaps even more complex in pediatric trauma, where the potential for saving life-years might prompt overtriage.…”

Section: Helicopter Transportation For Patients Meeting Physiologic Amentioning

confidence: 99%

“…54 After deriving a pediatric overtriage rate of 85% in their retrospective study, Moront et al also expressed concerns regarding pediatric overtriage. 39 Further confounding the analysis of this subject is the disputable time-savings of HEMS. Some studies found no difference in transport times for HEMS vs. GEMS, even when controlling for distance traveled.…”

Section: Helicopter Transportation For Patients Meeting Physiologic Amentioning

confidence: 99%

“…Future research is required to strengthen the data and recommendations, define optimal approaches for guideline implementation, and determine the impact of implementation on safety and outcomes including cost. Key words: Air ambulances; ambulances; emergency medical services; evidence-based emergency medicine; practice guidelines; trauma; triage PREHOSPITAL EMERGENCY CARE 2014;18(Suppl 1): [35][36][37][38][39][40][41][42][43][44] …”

mentioning

confidence: 99%

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An Evidence-based Guideline for the Air Medical Transportation of Prehospital Trauma Patients

Thomas¹,

Brown²,

Oliver³

et al. 2013

Prehospital Emergency Care

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Background. Decisions about the transportation of trauma patients by helicopter are often not well informed by research assessing the risks, benefits, and costs of such transport. Objective. The objective of this evidence-based guideline (EBG) is to recommend a strategy for the selection of prehospital trauma patients who would benefit most from aeromedical transportation. Methods. A multidisciplinary panel was recruited consisting of experts in trauma, EBG development, and emergency medical services (EMS) outcomes research. Representatives of the Federal Interagency Committee on Emergency Medical Services (FICEMS), the National Highway Traffic Safety Administration (NHTSA) (funding agency), and the Children's National Medical Center (investigative team) also contributed to the process. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to guide question formulation, evidence retrieval, appraisal/synthesis, and formulate recommendations. The process followed the National Evidence-Based Guideline Model Process, which has been approved by the Federal Interagency Committee on

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Section: Use Of the Cdc 2011 Guidelines For The Field Triage Of Injurmentioning

confidence: 99%

Section: Helicopter Transportation For Patients Meeting Physiologic Amentioning

confidence: 99%

Section: Helicopter Transportation For Patients Meeting Physiologic Amentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

An Evidence-based Guideline for the Air Medical Transportation of Prehospital Trauma Patients

Thomas¹,

Brown²,

Oliver³

et al. 2013

Prehospital Emergency Care

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“…The relative value of aeromedical transport compared with ground transport of children with multiple trauma is unclear and should be evaluated by individual EMS systems. [301][302][303] It is likely that mode of transport preference will depend on EMS system characteristics. BLS support requires meticulous attention to airway, breathing, and circulation from the moment of injury.…”

Section: Bls For the Trauma Victimmentioning

confidence: 99%

Part 9: Pediatric Basic Life Support

2000

Circulation

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• The extremely complex skills sequence for lay rescuer relief of foreign-body airway obstruction (FBAO) in the unconscious victim has been simplified. The sequence for healthcare provider relief of FBAO in the unconscious victim remains unchanged (Class IIb). IntroductionPediatric BLS refers to the provision of CPR, with no devices or with bag-mask ventilation or barrier devices, until advanced life support (ALS) can be provided. The population addressed in this chapter includes infants from birth to 1 year of age and children from 1 to 8 years of age. CPR and life support in the pediatric age group should be part of a community-wide Chain of Survival that links the child to the best hope of survival following emergencies. The Chain of Survival integrates education in prevention of cardiopulmonary arrest, BLS, early access to EMS systems prepared for children's needs, early and effective pediatric Sudden cardiopulmonary arrest in infants and children is much less common than sudden cardiac arrest in adults. 4 In contrast to cardiac arrest in adults, cardiac arrest in infants and children is rarely a sudden event, and non-cardiac causes predominate. 4 The etiology of cardiac arrest in infants and children varies by age, setting, and the underlying health of the child. For these reasons, the sequence of CPR for infants and children requires a different approach from that used for adult victims.Cardiac arrest in the under-21-year-old age group occurs most commonly at either end of the age spectrum: under 1 year of age and during the teenage years. In the newly born infant, respiratory failure is the most common cause of cardiopulmonary deterioration and arrest. During infancy the most common causes of arrest include sudden infant death syndrome (SIDS), respiratory diseases, airway obstruction (including foreign-body aspiration), submersion, sepsis, and neurological disease. [5][6][7][8][9][10][11] Beyond 1 year of age, injuries are the leading cause of death. [12][13][14] Cardiac arrest in children typically represents the terminal event of progressive shock or respiratory failure. Either shock or respiratory failure may include a compensated state from which children can rapidly deteriorate to a decompensated condition with progression to respiratory or cardiac arrest. Therefore, rescuers must detect and promptly treat early signs of respiratory and circulatory failure to prevent cardiac arrest. In children, early effective bystander CPR has been associated with successful return of spontaneous circulation and neurologically intact survival. 15,16 BLS courses should be offered to target populations such as expectant parents, child care providers, teachers, sports supervisors, and others who regularly care for children. Parents and child care providers of children with underlying conditions that predispose them to cardiopulmonary failure should be particularly targeted for these courses.These guidelines are based on a review and analysis of clinical and experimental evidence. 17 Because this evidence varies widely...

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