Validity of Helicopter Emergency Medical Services Dispatch Criteria for Traumatic Injuries: A Systematic Review

Ringburg, A.N.; Ronde, Gijs de; Thomas, Stephen; Lieshout, Esther M.M. Van; Patka, P.; Schipper, I.B.

doi:10.1080/10903120802472012

Cited by 61 publications

(62 citation statements)

References 50 publications

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“…This result may indicate a lower threshold for responding to trauma than to medical emergencies. The initial phase after an accident is often characterized by uncertainty, which may contribute to over‐triage in HEMS, as others have reported 23. A number of rescued hikers and skiers who sustain relatively minor trauma also reduced the median NACA for trauma patients in the current study.…”

Section: Discussionsupporting

confidence: 53%

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

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BackgroundThe Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km2. Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region.MethodsData from all HEMS dispatches during 2004–2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons.ResultsA total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on‐scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions.ConclusionOne third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10‐year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted.

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Section: Discussionsupporting

confidence: 53%

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

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“…28 Many laudable attempts to streamline prehospital trauma triage have attempted to identify anatomic, physiologic, or situational components that identify patients appropriate for advanced trauma care without resulting in substantial overtriage. [29][30][31] Reliance on physiologic criteria/vital signs alone, for instance, will likely result in unacceptable levels of undertriage, as patients with significant injuries may have normal vital signs at the scene. 32,33 The same concerns apply to triage decisions based solely on anatomic or situational factors.…”

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

confidence: 99%

“…32,33 The same concerns apply to triage decisions based solely on anatomic or situational factors. 31,34,35 The strength of evidence addressing patient morbidity and mortality associated with field triage decisions was judged to be low, largely due to the lack of prospective, large-scale trials. The prospective data that do exist are derivation studies or pilottesting of new triage parameters, such as heart-rate variability.…”

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

confidence: 99%

“…No single component demonstrated sufficient accuracy in narrowing the number of considered dispatch variables and the authors concluded that a more rigorous analysis was needed. 31 A retrospective registry review by Braithwaite et al found that patients with an ISS of 16-60 might have improved outcomes with HEMS. 53 A review panel led by Black selected decreased level of consciousness (LOC), airway obstruction, respiratory distress, shock, and significant head injury as the clinical features that should prompt HEMS activation.…”

Section: Helicopter Transportation For Patients Meeting Physiologic Amentioning

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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“…However, the data needed to improve the accuracy of these criteria and better align urgent resources with the needs of patients are limited. In a recent systematic review of criteria for dispatch of air transport for severely injured patients, Ringburg and colleagues 6 found that the validity of the criteria varied widely. They noted, for instance, that 22 of 49 discrete launch criteria were driven primarily by reported mechanism of injury.…”

mentioning

confidence: 99%

Urgent air-medical transport: Right patient, place and time

Isakov¹

2009

Canadian Medical Association Journal

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Validity of Helicopter Emergency Medical Services Dispatch Criteria for Traumatic Injuries: A Systematic Review

Abstract: Only 5 studies described HEMS dispatch criteria validity. HEMS dispatch based on consciousness criteria seems promising. MOI criteria lack accuracy and will lead to significant overtriage. The first categories needing revision are MOI and age/comorbidity.

Cited by 61 publications

References 50 publications

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

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

Urgent air-medical transport: Right patient, place and time

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