Physician-staffed helicopter scene response from a rural trauma center.

One hundred ten consecutive trauma patients transported directly from the scene of injury by a hospital-based helicopter emergency medical service were reviewed. These patients were injured in the rural areas of central and northeastern Pennsylvania and were transported to a level I trauma center. The medical flight team consisted of an emergency physician and a registered nurse. The average round-trip flight distance was 44 miles. The overall mortality was 21.8%. Eighty-eight percent of the injuries were motor vehicle related. Only two patients received advanced life support prior to arrival of the helicopter. Forty-five percent of patients required major intervention by the medical flight team at the scene. The average scene time was 33.6 minutes for transported patients. Sixteen patients required extrication after the arrival of the flight crew and had significantly prolonged scene times averaging 61.8 minutes (P less than .001). Patient entrapment was the most important contributing factor in on-scene ground time.