• Prehosp Emerg Care · Apr 2005

    Comparative Study

    EMS and emergency department physician triage: injury severity in trauma patients transported by helicopter.

    • Jeffrey S Lubin, Theodore R Delbridge, John S Cole, Dederia H Nicholas, Christopher A Fore, and Richard J Wadas.
    • Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. jeffrey.lubin@uhhs.com
    • Prehosp Emerg Care. 2005 Apr 1;9(2):198-202.

    BackgroundMany trauma patients who are not severely injured arrive at trauma centers via helicopter emergency medical services (HEMS).ObjectiveTo compare the injury severity of patients sent to trauma centers by HEMS from community emergency departments (EDs) with the injury severity of those triaged by prehospital providers to HEMS directly from accident scenes.MethodsAll records were reviewed from trauma-related missions during 1997for a single HEMS system, extracting information on location, time of day, patient age and gender, mechanism of injury, initial vital signs, Revised Trauma Score (RTS), and the extent of care required during transport. These records were then matched with outcome information routinely supplied to the HEMS system by affiliated trauma centers. Information from patients flown directly from scenes was then compared with that for patients flown from community EDs.ResultsInformation was obtained for 658 patients flown from scenes and 345 flown from community EDs. There were similar proportions of patients in the two groups, with Injury Severity Scale (ISS) scores less than 6 (11.0% vs. 13.5%), between 6 and 14 (47.0% vs. 49.3%), and greater than 15 (42.0% vs. 37.1%); these were not statistically different (p > 0.05). There was also no significant difference between the groups in the RTS, mean ISS score, intensive care unit length of stay, hospital length of stay, or disposition.ConclusionsScene and interhospital HEMS trauma missions in this system involve patients of similar injury severities. Prehospital providers may triage trauma patients to HEMS transport with proficiency similar to that of community ED physicians.

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