Air versus Ground Vehicle Decisions for Interfacility Air Medical Transport

摘要

In emergency medical transport, "time to definite care" is very important. In the setting of a trauma patient, this time interval is referred to as "the golden hour" in recognition that transport to a designated trauma centre positively impacts patient outcome. The same is true for other time-sensitive conditions such as acute myocardial infarction, acute ischemic stroke, and sepsis. Emergency medical services and transport medicine agencies have several possible vehicle options for interfacility transfers. Use of a land vehicle, helicopter, or fixed wing aircraft will be dependent on patient condition, distance between sending and receiving hospitals, crew configuration and capabilities, and other factors such as weather and road conditions. This paper lays out the complex process of patient transfers and highlights the challenges in decision making. It then describes the behaviour of human operators in estimating time to definite care and provides recommendations to improve their estimation. Analysis of a historical dataset on interfacility transfers revealed that time to definite care estimates deviate significantly from observed times. Further, transfers which involve a helicopter appear to be highly underestimated. In fact, 44% of transfers involving a helicopter were underestimated by more than 60 minutes.