Does Direct Helicopter Retrieval Improve Survival of Severely Injured Trauma Patients From Rural Western Australia?

Abstract

ObjectiveIn remote Western Australia, mortality from major trauma is more than 4 times higher than mortality rates from major trauma in the capital city of Perth. The objective of this study was to determine whether direct helicopter emergency medical service (HEMS) retrieval from an incident scene within the zone 50 to 250 km of Perth to a tertiary hospital improves survival in severely injured trauma patients. Direct HEMS retrieval was compared with indirect retrieval whereby patients were transferred by ambulance to a nearby rural hospital before retrieval to a tertiary hospital in Perth. MethodsA retrospective analysis (2006-2015) was undertaken of all Western Australia trauma registries, and coronial data were collected for all major trauma patients who died before retrieval to a tertiary hospital in Perth. ResultsA total of 1,374 major trauma patients (indirect retrieval = 1,031 and direct HEMS = 343) met the study inclusion criteria. There was a 51% increased risk of death in the indirect patients compared with the direct HEMS patients (15.3% vs. 10.2%, P ≤ .001). ConclusionDirect HEMS retrieval from the incident scene to a tertiary hospital substantially improves the chances of survival for severely injured trauma patients in rural locations in the zone 50 to 250 km of Perth.