Appropriate use of helicopter emergency medical services for transport of trauma patients: Guidelines from the emergency medical system subcommittee, committee on trauma, American college of surgeons

摘要

A "trauma system" as defined by the American College of Surgeons' Committee on Trauma (ACSCOT) includes prehospital care of the trauma patient, including the emergency medical system (EMS) and helicopter emergency medical services (HEMS).1 Appropriate use of HEMS for trauma patients can save lives. Inappropriate use of HEMS is a costly waste of health care resources and increases risk to patients and HEMS crews. Unfortunately, HEMS resources often operate outside the confines of an inclusive and integrated trauma and EMS system. The Airline Deregulation Act of 1978 left the authority to regulate the air medical industry to a largely nonmedical entity, the Federal Aviation Administration (FAA). In 2006, the Institute of Medicine specifically recommended that states be allowed to regulate the medical aspects of the system, so that "states assume regulatory oversight of the medical aspects of air medical services, including communications, dispatch, and transport protocols."2 A 2009 National Transportation Safety Board (NTSB) investigation into a surge in fatal HEMS accidents led to recommendations to the Federal Interagency Commission on Emergency Medical Services (FICEMS) to develop national guidelines for the use and availability of HEMS by regional, state, and local authorities during emergency medical response system planning, including the integration of HEMS into the EMS system and the selection of patients,for appropriate emergency transportation modes for urgent care.3