Helicopter emergency medical services for adults with major trauma

Abstract

Trauma is a leading cause of death and disability worldwide and, since the 1970s, helicopters have been used to transport people with injuries to hospitals that specialise in trauma care. Helicopters offer several potential advantages, including faster transport to expert medical care and treatment en route to the hospital by providers who are specifically trained in trauma management. Twenty-five studies conducted internationally compared transport by helicopter emergency medical services to transport by ground emergency medical services (an ambulance), with both types of service aiming to improve either survival or disability for seriously injured patients. Some of these studies indicated some benefit of helicopter transport for survival after major trauma, but others did not. The studies were of varying sizes and different methods were used to determine if more patients survived when transported by helicopter versus ground ambulances. Some studies included helicopter teams that had specialised physicians on board whereas other helicopter crews were staffed by paramedics and nurses. Furthermore, patients transported by helicopter or ground emergency medical services had varying numbers and types of procedures en route to the trauma centre. The use of some of these procedures, such as the placement of a breathing tube, may have helped improve survival in some of the studies. Overall the quality of the included studies was low. Helicopter transport for some trauma patients may be beneficial for a variety of reasons and more research is required to determine what elements of helicopter transport help improve outcomes. The results from future research might help in better allocation of the helicopter transport resource with increased safety and decreased costs.