Interfacility Helicopter Transport At A Tertiary Pediatric Trauma Center
Kelli N Patterson1, Tariku Beyene1, Katherine Bergus2, Jordan Stafford2, LeeAnn Wurster1, *Rajan Thakkar1
1Nationwide Children's Hospital, Columbus, OH;2Ohio State University, Columbus, OH
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 aged 0-18 years undergoing either IHT or interfacility ground transport (IGT) to our institution from January 2011-December 2020 were studied. We evaluated the frequency of IHT patients undergoing emergent (1 hour), urgent (6 hours), and semi-urgent (48 hours) operating room (OR) intervention compared to IGT. FINDINGS: Inclusion was met by 1003 IHT and 7830 IGT patients. OR intervention was required in 297(29.6%) IHT patients, emergent in 13(1.3%), urgent in 126(12.6%) and semi-urgent in 106(10.6%). IHT patients had a median injury severity score (ISS) of 9(IQR: 4-17), with 313(32.1%) having ISS ≥15, compared to IGT patients (ISS:4(1-6),p<0.01). Black, Asian, and Hispanic patients had a lower likelihood of helicopter transport (p<0.01). No difference was seen in median ISS across IHT patients requiring emergent, urgent and semi-urgent intervention (p=0.69). A higher proportion of IHT patients required emergent and urgent intervention compared to IGT patients (p<0.01). CONCLUSIONS: More IHT patients underwent emergent and urgent procedures compared to IGT patients; however, emergent intervention was not required in 98.7% of IHT patients and two-thirds had ISS <15, possibly suggesting overutilization of IHT for pediatric trauma transport at our center.
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