Background: Helicopter emergency medical services (HEMS) are intended to expedite care to definitive management. Studies are inconclusive in demonstrating appropriate use. We aimed to examine emergent interventions after interfacility helicopter transport (IHT) to our pediatric trauma center.
Methods: Trauma patients 0-18 years undergoing IHT or interfacility ground transport (IGT) to our institution from January 2011-December 2020 were studied. We evaluated the rate of IHT patients undergoing emergent (1 h), urgent (6 h), and semi urgent (48 h) operating room (OR) intervention compared to IGT as a measure of appropriate transport.
Results: Inclusion was met by 1003 IHT and 7829 IGT patients. OR intervention was required in 29.6% of IHT patients, emergent in 1.3%, urgent in 12.6%, and semi urgent in 10.6%. Overall, IHT patients had higher mean injury severity score (ISS; IHT:14.5; SD:11.0 vs. IGT:6.0; SD:5.0; p < 0.01) and lower GCS (IHT:12.0; SD:4.9 vs. IGT:14.8; SD:1.4; p < 0.01), though over triage (ISS ≤ 15) occurred in 67.9% of patients.
Conclusion: More interfacility helicopter transport patients underwent emergent and urgent procedures compared to interfacility ground transport patients; however, emergent intervention was not required in 98.7% of interfacility helicopter transport patients and over two thirds had ISS ≤ 15, possibly suggesting overutilization of interfacility helicopter transport for pediatric trauma patients at our center.
Level of evidence: Level III.
Keywords: Critical care; General surgery; Pediatrics; Transportation.
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