Rapid Ground Transport of Trauma Patients: A?Moderate Distance From Trauma Center Improves Survival

摘要

BackgroundThere is debate within the emergency medical services (EMS) community over the value of calling a helicopter for trauma patients within a moderate distance/<45?min, of a trauma center. Helicopter EMS (HEMS) generally have a wider scope and more advanced training than the ground EMS (GEMS). GEMS, on the other hand, have the benefit of being able to immediately initiate rapid transport to the trauma center without the delay involved with HEMS flying to the scene, landing, and assuming patient care. MethodsWe retrospectively analyzed patients brought to a level I trauma center who were admitted with blunt traumatic injuries between 2010 and 2015 in the Trauma Quality Improvement Program database. Two analyses were performed, one in which the patient's reported initial scene vitals met criteria for step one of the Centers for Disease Control's 2011 National Field Triage Guidelines (NFTG) and the other in which the patient's initial scene vitals met those same guidelines and/or had a pulse greater than 110 beats per minute. Patients were categorized on scene to emergency department (ED) transport mode, either HEMS or GEMS. Inclusion criteria were a HEMS response time to the scene that was between 15 and 45?min with a transport time from the scene to the ED that was between 10 and 35?min or a GEMS transport time from the scene to the ED that was between 15 and 45?min. Statistical significance (P?