The benefits and cost effectiveness of helicopter transport for severely injured patients is of continued debate. New research published in BioMed Central's open access journal Critical Care shows that for severe blunt trauma, patients transported by helicopter had a lower risk of death, compared to those transported by road.
In a multi-centre study, based in university hospitals across France, researchers compared initial patient status at the scene of the accident, with time taken to get to hospital, type of treatment received pre-admission, and to health at discharge, or after 30 days.
At first there seemed to be no difference in mortality between those transported by helicopter and those by road, however once the data had been adjusted for severity of injury the results became clear. Patients transported by helicopter stood a better chance of survival than those transported by road.
Dr Thibaut Desmettre, who led this study, explained, "Transporting very ill patients is a balancing act. Overall it took longer for patients transported by helicopter to reach hospital and they tended to need more emergency care once admitted. On the other hand these patients were more intensively treated at the scene and en route than those transported by road-ambulance crews -- which might go some way towards explaining their improved chances of survival."
However the benefit seen could not all be attributed to the more aggressive therapy they received before, or after, they arrived at hospital. Dr Desmettre continued, "We were unable to measure the distance the patients travelled, nor where their accident occurred -- some accidents occur in places where road access is too difficult -- and what impact this had on severity of injury or choice of sending a helicopter crew." Helicopters are a costly and limited resource and unfortunately the benefit to patients has to evaluated in this light. However, for these patients, with the most severe injuries, transport by helicopter saves lives.
- Thibaut Desmettre, Jean-Michel Yeguiayan, Hervι Coadou, Claude Jacquot, Mathieu Raux, Benoit Vivien, Claude Martin, Claire Bonithon-Kopp, Marc Freysz and French Intensive care Recorded in Severe Trauma. Impact of emergency medical helicopter transport directly to a university hospital trauma center on mortality of severe blunt trauma patients until discharge. Critical Care, (in press) [link]
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