Introduction
This study aims to compare the trauma system before and after implementing a physician‐staffed helicopter emergency medical service (PS‐HEMS). Our hypothesis was that PS‐HEMS would reduce time from injury to definitive care for severely injured patients.
Methods
This was a prospective, controlled, observational study, involving seven local hospitals and one level I trauma centre using a before and after design. All patients treated by a trauma team within a 5‐month period (1 December 2009–30 April 2010) prior to and a 12‐month period (1 May 2010–30 April 2011) after implementing a PS‐HEMS were included.
We compared time from dispatch of the first ground ambulance to arrival in the trauma centre for patients with Injury Severity Score (ISS) > 15. Secondary end points were the proportion of secondary transfers and 30‐day mortality.
Results
We included 1788 patients, of which 204 had an ISS > 15. The PS‐HEMS transported 44 severely injured directly to the trauma centre resulting in a reduction of secondary transfers from 50% before to 34% after implementation (P = 0.04). Median delay for definitive care for severely injured patients was 218 min before and 90 min after implementation (P < 0.01). The 30‐day mortality was reduced from 29% (16/56) before to 14% (21/147) after PS‐HEMS (P = 0.02). Logistic regression showed PS‐HEMS had an odds ratio (OR) for survival of 6.9 compared with ground transport.
Conclusions
Implementation of a PS‐HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30‐day mortality.