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Flightmed archive for October-2003



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Re: Articles Supporting Air Medical Transport



Smarty pants.

>>> MAFRAKES@aol.com 10/21/03 11:06AM >>>
Susan Smith identified some excellent articles and also the important
point 
that the studies are widely variable.   A few other papers that may be
helpful 
are:
1)           Kerr WA.  Differences in mortality rates among trauma
patients 
transported by helicopter and ambulance in Maryland.  Prehosp Disaster
Med 
1999;14(3):159-64.  {Large study of scene trauma outcomes comparing
ground v. air 
transport.  Air transport outcomes are better and the difference grows
as 
acuity increases.}
2)           Moront ML, Gotschall CS, Eichelberger MR.  Helicopter
transport 
of injured children:  system effectiveness and triage criteria.  J
Pediatr 
Surg 1996;31(8):1183-8. {Large pediatric survey.  Outcomes are improved
with air 
transport, but overtriage is high.}
3)           Mann NC, Pinkney KA, Price DD, et al.  Injury mortality 
following the loss of air medical support for rural interhospital
transport.  Acad 
Emerg Med 2002;9(7):694-8.  {"Natural experiment" after transport
program is 
discontinued.  Mortality of transferred patients increases by 400%.}
4)           Falcone RE.  Air medical transport of the injured patient:
 
scene versus referring hospital.  Air Med J 1998;17(4):161-5. 
{Transport to 
community hospital with subsequent air transfer carries increased risk
of 
complication and preventable death when compared with direct air
transport from scene 
to trauma center.}
5)           Berns KS, Hankins DG, Zietlow SP.  Comparison of air and
ground 
transport of cardiac patients.  Air Med J 2001;20(6):33-6  {Cardiac
patients 
transferred by air arrive with more interventions, less pain, and have
shorter 
LOS than similar patients transported by ground.}
If it helps to have more identifying information for two of the
articles 
Susan cited, 
1)           Thomas SH, Harrison TH, Buras WR, et al.  Helicopter
transport 
and blunt trauma mortality:  a multicenter trial.  J Trauma
2002;52:136-45.
2)      Jacobs LM, Gabram SG, Robinson KJ, et al.  Helicopter air
medical 
transport:  ten-year outcomes for trauma patients in a New England
program.  Conn 
Med 1999;63(11):677-82.
There is also a body of literature reporting no benefit from air
medical 
transport.  
Michael Frakes BSN, CFRN, CCRN, EMTP, FP-C
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