The hot-loaded patient: Review and analysis of 1 year's experience

Abstract

Introduction: Hot-loading is a common practice among rotor-wing air medical programs that respond to scene calls. Drawbacks include noise, flying debris, and risk of serious injury. The purpose of this study was to identify the frequency, ground time, and short-term outcomes of hot-loaded patients flown by the STAR Flight program. Methods: A 1-year retrospective records review identified all hot-loaded patients. Results were analyzed by call nature, number of patients, and type of aircraft. Results: In 1996 STAR Flight transported 1184 individuals from the scene of illness or injury; 269 (23%) were hot-loaded. Overall, hot-load ground times averaged 7.0 minutes. The shortest mean time, 6.6 minutes, was for single trauma patients. Medicine patients averaged 7.3 minutes, and multipatient transports required 10.3 minutes. Mean scene times for those flown in the Bell 412 and 206 were 6.9 and 7.4 minutes, respectively. Thirty percent of hot-loaded patients were considered critical. Conclusion: Hot-loading rarely was accomplished in less than the helicopter shutdown/startup time. Multipatient hot-loads always exceeded shutdown/restart intervals. Medicine and Bell 206 transports required the longest mean ground times. Most of STAR Flight's hot-loaded patients were not critically ill or injured.