A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre
Background: KwaZulu-Natal, the largest land mass province that is densely populated in SA has vast distances to referral centres and time to definitive treatment is key in trauma care. Helicopter Emergency Medical Service (HEMS) is still an invaluable prehospital asset for the transport of time sens...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
|
| Series: | African Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2211419X22000143 |
| _version_ | 1811341733075615744 |
|---|---|
| author | Marwala Simon Pule Peter Hodkinson Timothy Hardcastle |
| author_facet | Marwala Simon Pule Peter Hodkinson Timothy Hardcastle |
| author_sort | Marwala Simon Pule |
| collection | DOAJ |
| description | Background: KwaZulu-Natal, the largest land mass province that is densely populated in SA has vast distances to referral centres and time to definitive treatment is key in trauma care. Helicopter Emergency Medical Service (HEMS) is still an invaluable prehospital asset for the transport of time sensitive trauma. This study reviews the impact of HEMS in the management of trauma at Inkosi Albert Luthuli hospital (IALCH) which is the only public accredited level one trauma centre in the province. Methods: A retrospective descriptive study of polytrauma patients transported by HEMS in KZN to IALCH over a three-year period from 01 January 2014 to 31 December 2016. Data was collected around patient demographics, transfer details and patient outcomes. Results: Over the three-year period, 117 HEMS transfers were reviewed, with the majority being male (90.6%). Just 26% of HEMS transfers were direct from the scene, with the balance being interhospital transfers largely from distant regional hospitals around the province. Some 60% of injuries were caused by vehicle crashes, and 31% by intentional injury. Mortality was 30% which is reflective of the high severity of injury of the cohort. The injury severity scores (ISS) (median 26 overall) of those who died was higher (median 38) (P-= .0002), and there were more interventions before and during transfer such as thoracostomy, ventilation and immobilization. Overall, 88% required admission to ICU at IACLH. Conclusions: HEMS in the KwaZulu Natal province was mainly used for long-distance transfer of major trauma patients which is an appropriate use of this essential service, given the single major trauma centre in the province. The majority of patients that were transported by HEMS had severe injury, which was also associated with increased mortality outcomes. Rational use of this essential but expensive resource will require clear policy around the role of HEMS and call out criteria in each setting. |
| first_indexed | 2024-04-13T18:58:25Z |
| format | Article |
| id | doaj.art-8605c2669d0c4b8699544ae33e989061 |
| institution | Directory Open Access Journal |
| issn | 2211-419X |
| language | English |
| last_indexed | 2024-04-13T18:58:25Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | African Journal of Emergency Medicine |
| spelling | doaj.art-8605c2669d0c4b8699544ae33e9890612022-12-22T02:34:10ZengElsevierAfrican Journal of Emergency Medicine2211-419X2022-09-01123183190A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centreMarwala Simon Pule0Peter Hodkinson1Timothy Hardcastle2Candidate MPhil Emergency Medicine University of Cape Town; Corresponding author.Division of Emergency Medicine, University of Cape TownHead Clinical Department: Trauma and Burns, Inkosi Albert Luthuli Central Hospital and DoH-KZN, Honorary Research Associate Professor in Health Sciences – DUT, Honorary Associate Professor of Trauma and Surgery – UKZNBackground: KwaZulu-Natal, the largest land mass province that is densely populated in SA has vast distances to referral centres and time to definitive treatment is key in trauma care. Helicopter Emergency Medical Service (HEMS) is still an invaluable prehospital asset for the transport of time sensitive trauma. This study reviews the impact of HEMS in the management of trauma at Inkosi Albert Luthuli hospital (IALCH) which is the only public accredited level one trauma centre in the province. Methods: A retrospective descriptive study of polytrauma patients transported by HEMS in KZN to IALCH over a three-year period from 01 January 2014 to 31 December 2016. Data was collected around patient demographics, transfer details and patient outcomes. Results: Over the three-year period, 117 HEMS transfers were reviewed, with the majority being male (90.6%). Just 26% of HEMS transfers were direct from the scene, with the balance being interhospital transfers largely from distant regional hospitals around the province. Some 60% of injuries were caused by vehicle crashes, and 31% by intentional injury. Mortality was 30% which is reflective of the high severity of injury of the cohort. The injury severity scores (ISS) (median 26 overall) of those who died was higher (median 38) (P-= .0002), and there were more interventions before and during transfer such as thoracostomy, ventilation and immobilization. Overall, 88% required admission to ICU at IACLH. Conclusions: HEMS in the KwaZulu Natal province was mainly used for long-distance transfer of major trauma patients which is an appropriate use of this essential service, given the single major trauma centre in the province. The majority of patients that were transported by HEMS had severe injury, which was also associated with increased mortality outcomes. Rational use of this essential but expensive resource will require clear policy around the role of HEMS and call out criteria in each setting.http://www.sciencedirect.com/science/article/pii/S2211419X22000143HEMSTraumaOutcomePre-hospital careSouth Africa |
| spellingShingle | Marwala Simon Pule Peter Hodkinson Timothy Hardcastle A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre African Journal of Emergency Medicine HEMS Trauma Outcome Pre-hospital care South Africa |
| title | A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| title_full | A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| title_fullStr | A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| title_full_unstemmed | A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| title_short | A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| title_sort | descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre |
| topic | HEMS Trauma Outcome Pre-hospital care South Africa |
| url | http://www.sciencedirect.com/science/article/pii/S2211419X22000143 |
| work_keys_str_mv | AT marwalasimonpule adescriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre AT peterhodkinson adescriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre AT timothyhardcastle adescriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre AT marwalasimonpule descriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre AT peterhodkinson descriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre AT timothyhardcastle descriptivestudyoftraumapatientstransportedbyhelicopteremergencymedicalservicestoalevelonetraumacentre |