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KMID : 0387320180280040085
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Korean Journal of Health Policy and Administration
2018 Volume.28 No. 4 p.85 ~ p.96
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Effectiveness of the Trauma Team-Staffed Helicopter Emergency Medical Service
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Kim Tea-Youn
Lee Sang-Ah
Park Eun-Cheol
Huh Yo
Jung Kyoung-Won
Kwon Jun-Sik
Moon Jong-Hwan
Kim Ji-Young
Kim Ju-Ryang
Hwang Kyung-Jin
Yun Seong-Keun
Lee Cook-Jong
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Abstract
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Background: Whether there is a difference in outcomes for trauma patients transferring to the helicopter emergency medical service (HEMS) according to their previous team composition is controversial. The purpose of this study is to evaluate the effectiveness of trauma team-staffed-HEMS (TTS-HEMS) when transferring to a trauma center.
Methods: A retrospective comparison was conducted on patients transported to a trauma center over a 6-year period by the TTS-HEMS and paramedic-staffed-HEMS (119-HEMS). Inclusion criteria were blunt trauma with age ≥15 years. Patient outcomes were compared with the Trauma and Injury Severity Score (TRISS) (30-day mortality) and the Cox proportional hazard ratio of mortality (in hospital).
Results: There were 321 patients of TTS-HEMS and 92 patients of 119-HEMS. The TTS-HEMS group had a higher Injury Severity Score and longer transport time but a significantly shorter time to emergency surgery. The prehospital data showed that the trauma team performed more aggressive interventions during transport. An additional 7.6 lives were saved per 100 TTS-HEMS deployments. However, the TRISS results in the 119-HEMS group were not significant. In addition, after adjusting for confounders, the hazard ratio of mortality in the 119-HEMS group was 2.83 times higher than that in the TTS-HEMS group.
Conclusion: HEMS was likely to improve the survival rate of injured patients when physicians were involved in TTS-HEMS. Survival benefits in the TTS-HEMS group appeared to be related to the fact that the trauma team performed both more aggressive prehospital resuscitation and clinical decision making during transportation.
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KEYWORD
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Helicopter emergency medical service, Injury, Injury Severity Score, Trauma centers
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