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Citation
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Stewart CL, Metzger RR, Pyle L, Darmofal J, Scaife E, Moulton SL. J. Pediatr. Surg. 2015; 50(2): 347-352. |
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Affiliation
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University of Colorado School of Medicine, Department of Surgery, 12631 E. 17th Ave, C302, Aurora, CO 80045; Children's Hospital Colorado, Division of Pediatric Surgery, 13123 E. 16th Ave, B232, Aurora, CO 80045. Electronic address: Steven.Moulton@childrenscolorado.org. |
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Abstract
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BACKGROUND: Helicopter emergency medical services (HEMS) are a common mode of transportation for pediatric trauma patients. We hypothesized that HEMS improve outcomes for traumatically injured children compared to ground emergency medical services (GEMS).
METHODS: We queried trauma registries of two level 1 pediatric trauma centers for children 0-17years, treated from 2003 to 2013, transported by HEMS or GEMS, with known transport starting location and outcome. A geocoding service estimated travel distance and time. Multivariate regression analyses were performed to adjust for injury severity variables and travel distance/time.
RESULTS: We identified 14,405 traumatically injured children; 3870 (26.9%) transported by HEMS and 10,535 (73.1%) transported by GEMS. Transport type was not significantly associated with survival, ICU length of stay, or discharge disposition. Transport by GEMS was associated with a 68.6%-53.1% decrease in hospital length of stay, depending on adjustment for distance/time.
RESULTS were similar for children with severe injuries, and with propensity score matched cohorts. Of note, 862/3850 (22.3%) of HEMS transports had an ISS <10 and hospitalization <1day.
CONCLUSIONS: HEMS do not independently improve outcomes for traumatically injured children, and 22.3% of children transported by HEMS are not significantly injured. These factors should be considered when requesting HEMS for transport of traumatically injured children.
Language: en |