Usefulness of Key Word Methods to Execute Early Requests for a Physician-Staffed Helicopter Emergency Medical Service Dispatch to Facilitate Early Medical Intervention by Physicians

Abstract

ObjectiveA physician-staffed helicopter emergency medical service is called a doctor helicopter (DH) in Japan. We retrospectively investigated this service using a data bank provided by the Japan DH registry system. MethodsThe following details of the dispatch activity were collected: patient age and sex, vital signs (Japan Coma Scale [JCS], systolic blood pressure, heart rate, and respiratory rate) at the scene measured by emergency medical technicians (EMTs), dispatch of the DH before the EMTs made contact with patients (key words group) or after (control group), and the survival outcome at 1 month. ResultsDuring the investigation period, 28,357 patient records were analyzed (key words group, n = 13,861; control group, n = 14,496). The age, JCS, and respiratory rate were significantly smaller in the key words group than in the control group. The rates of male sex and survival in the key words group were significantly greater than those in the control group. In the multivariate analysis, dispatch of the DH after EMTs made contact with the patients (odds ratio [OR] = 0.72; 95% confidence interval [CI], 0.55-0.92), female sex (OR = 0.86; 95% CI, 0.75-0.98), older age (OR = 0.97; 95% CI, 0.96-0.97), elevated respiratory rate (OR = 0.97; 95% CI, 0.97-0.98), and high JCS (OR = 0.99; 95% CI, 0.99-0.99) were associated with a decreased 1-month survival (P > .0001). ConclusionThis is the first report to describe the key words method as a potential factor influencing optimal outcomes/potential survival rates in patients evacuated by the DH using the JDRS. Our study results suggest that the firefighting central command room should consider adopting the key words method when the helicopter emergency medical service is used.