Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.

BACKGROUND AND AIM: Prehospital care of trauma patients is a matter of great debate. The optimal transport method remains undecided, with conflicting data comparing helicopter and ground emergency medical transfer. This study systematically reviews the evidence comparing helicopter and ground trans...

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Main Authors: Butler, D, Anwar, I, Willett, K
Format: Journal article
Language:English
Published: 2010
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author Butler, D
Anwar, I
Willett, K
author_facet Butler, D
Anwar, I
Willett, K
author_sort Butler, D
collection OXFORD
description BACKGROUND AND AIM: Prehospital care of trauma patients is a matter of great debate. The optimal transport method remains undecided, with conflicting data comparing helicopter and ground emergency medical transfer. This study systematically reviews the evidence comparing helicopter and ground transfer of trauma patients from the scene of injury. METHODS: A systematic literature review of all population-based studies evaluating the impact on mortality of helicopter transfer of trauma patients from the scene of injury. We searched MEDLINE, CINAHL and EMBASE from January 1980 to December 2008 and selected and reviewed potentially relevant studies. RESULTS: A search of the literature revealed 23 eligible studies. 14 of these studies demonstrated a significant improvement in trauma patient mortality when transported by helicopter from the scene. 5 of the 23 studies were of level II evidence with the remainder being of level III evidence. Data were then entered into an evidence table and reference made to transport staffing, intubation rate, time at scene and time/distance of transfer. CONCLUSIONS: The role and structure of HEMS in a modern trauma service is a debate that is likely to continue. Prehospital care design should be specific to critical incident frequency, geographical arrangements of hospital facilities and travel times within each trauma network. It is also important to consider the benefits and capabilities of the emergency medical team separately from the transport method being considered. An effective helicopter EMS will ultimately depend on effective operating procedures and tasking protocols, clinical governance, and auditing of the helicopter EMS activity.
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spelling oxford-uuid:05531555-d50c-4d40-a639-8adb0fbb0a192022-03-26T08:56:32ZIs it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:05531555-d50c-4d40-a639-8adb0fbb0a19EnglishSymplectic Elements at Oxford2010Butler, DAnwar, IWillett, K BACKGROUND AND AIM: Prehospital care of trauma patients is a matter of great debate. The optimal transport method remains undecided, with conflicting data comparing helicopter and ground emergency medical transfer. This study systematically reviews the evidence comparing helicopter and ground transfer of trauma patients from the scene of injury. METHODS: A systematic literature review of all population-based studies evaluating the impact on mortality of helicopter transfer of trauma patients from the scene of injury. We searched MEDLINE, CINAHL and EMBASE from January 1980 to December 2008 and selected and reviewed potentially relevant studies. RESULTS: A search of the literature revealed 23 eligible studies. 14 of these studies demonstrated a significant improvement in trauma patient mortality when transported by helicopter from the scene. 5 of the 23 studies were of level II evidence with the remainder being of level III evidence. Data were then entered into an evidence table and reference made to transport staffing, intubation rate, time at scene and time/distance of transfer. CONCLUSIONS: The role and structure of HEMS in a modern trauma service is a debate that is likely to continue. Prehospital care design should be specific to critical incident frequency, geographical arrangements of hospital facilities and travel times within each trauma network. It is also important to consider the benefits and capabilities of the emergency medical team separately from the transport method being considered. An effective helicopter EMS will ultimately depend on effective operating procedures and tasking protocols, clinical governance, and auditing of the helicopter EMS activity.
spellingShingle Butler, D
Anwar, I
Willett, K
Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title_full Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title_fullStr Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title_full_unstemmed Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title_short Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence.
title_sort is it the h or the ems in hems that has an impact on trauma patient mortality a systematic review of the evidence
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AT willettk isitthehortheemsinhemsthathasanimpactontraumapatientmortalityasystematicreviewoftheevidence