Camille L Stewart1, Ryan R Metzger2, Laura Pyle3, Joe Darmofal4, Eric Scaife5, Steven L Moulton6. 1. University of Colorado School of Medicine, Department of Surgery, 12631 E. 17th Ave, C302, Aurora, CO 80045; Children's Hospital Colorado, Division of Pediatric Surgery, 13123 E. 16th Ave, B232, Aurora, CO 80045. Electronic address: Camille.Stewart@ucdenver.edu. 2. Primary Children's Hospital, Division of Pediatric Surgery, 100 N Mario Capecchi Dr, Suite 2600, Salt Lake City, UT 84113. Electronic address: metzger2020@gmail.com. 3. University of Colorado School of Medicine, Department of Pediatrics, 13001 E. 17th Place, C290, Aurora, CO 80045. Electronic address: Laura.Pyle@ucdenver.edu. 4. Children's Hospital Colorado, Department of Transport & EMS Outreach and Education, 13123 E. 16th Ave, B245, Aurora, CO 80045. Electronic address: Joe.Darmofal@childrenscolorado.org. 5. Primary Children's Hospital, Division of Pediatric Surgery, 100 N Mario Capecchi Dr, Suite 2600, Salt Lake City, UT 84113. Electronic address: Eric.Scaife@imail2.org. 6. University of Colorado School of Medicine, Department of Surgery, 12631 E. 17th Ave, C302, Aurora, CO 80045; Children's Hospital Colorado, Division of Pediatric Surgery, 13123 E. 16th Ave, B232, Aurora, CO 80045. Electronic address: Steven.Moulton@childrenscolorado.org.
Abstract
BACKGROUND: Helicopter emergency medical services (HEMS) are a common mode of transportation for pediatric trauma patients. We hypothesized that HEMS improve outcomes for traumatically injured children compared to ground emergency medical services (GEMS). METHODS: We queried trauma registries of two level 1 pediatric trauma centers for children 0-17 years, treated from 2003 to 2013, transported by HEMS or GEMS, with known transport starting location and outcome. A geocoding service estimated travel distance and time. Multivariate regression analyses were performed to adjust for injury severity variables and travel distance/time. RESULTS: We identified 14,405 traumatically injured children; 3870 (26.9%) transported by HEMS and 10,535 (73.1%) transported by GEMS. Transport type was not significantly associated with survival, ICU length of stay, or discharge disposition. Transport by GEMS was associated with a 68.6%-53.1% decrease in hospital length of stay, depending on adjustment for distance/time. Results were similar for children with severe injuries, and with propensity score matched cohorts. Of note, 862/3850 (22.3%) of HEMS transports had an ISS<10 and hospitalization<1 day. CONCLUSIONS: HEMS do not independently improve outcomes for traumatically injured children, and 22.3% of children transported by HEMS are not significantly injured. These factors should be considered when requesting HEMS for transport of traumatically injured children.
BACKGROUND: Helicopter emergency medical services (HEMS) are a common mode of transportation for pediatric traumapatients. We hypothesized that HEMS improve outcomes for traumatically injured children compared to ground emergency medical services (GEMS). METHODS: We queried trauma registries of two level 1 pediatric trauma centers for children 0-17 years, treated from 2003 to 2013, transported by HEMS or GEMS, with known transport starting location and outcome. A geocoding service estimated travel distance and time. Multivariate regression analyses were performed to adjust for injury severity variables and travel distance/time. RESULTS: We identified 14,405 traumatically injured children; 3870 (26.9%) transported by HEMS and 10,535 (73.1%) transported by GEMS. Transport type was not significantly associated with survival, ICU length of stay, or discharge disposition. Transport by GEMS was associated with a 68.6%-53.1% decrease in hospital length of stay, depending on adjustment for distance/time. Results were similar for children with severe injuries, and with propensity score matched cohorts. Of note, 862/3850 (22.3%) of HEMS transports had an ISS<10 and hospitalization<1 day. CONCLUSIONS: HEMS do not independently improve outcomes for traumatically injured children, and 22.3% of children transported by HEMS are not significantly injured. These factors should be considered when requesting HEMS for transport of traumatically injured children.
Authors: Paulo C M Colbachini; Fernando A L Marson; Andressa O Peixoto; Luisa Sarti; Andrea M A Fraga Journal: Front Pediatr Date: 2022-06-02 Impact factor: 3.569
Authors: Joshua B Brown; Christine M Leeper; Jason L Sperry; Andrew B Peitzman; Timothy R Billiar; Barbara A Gaines; Mark L Gestring Journal: J Trauma Acute Care Surg Date: 2016-05 Impact factor: 3.313