EMS World

JUL 2011

EMS World Magazine is the most authoritative source in the world for clinical and educational material designed to improve the delivery of prehospital emergency medical care.

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NEWS NETWORK For the seriously injured patient not close to a trauma center, HEMS appears to have a role in improving patient care. SULLIVENT EE, FAUL M, Wald MM. Reduced mortality in injured adults transported by helicopter emergency medical services. Prehosp Emerg Care, Apr 27, 2011 [e-pub ahead of print]. ANGELO SALVUCCI is a featured speaker at EMS World Expo 2011, August 29–September 2, at the Las Vegas Convention Center, Las Vegas, NV. For more information, visit EMSWorldExpo.com. ABSTRACT Background—Some studies have shown improved outcomes with helicopter emergency medical services (HEMS) transport, while others have not. Safety concerns and cost have prompted reevaluation of the widespread use of HEMS. Objective—To determine whether the mode of transport of trauma patients affects mortality. Methods—Data for 56,744 injured adults aged greater than or equal to 18 PRODUCT NEWS IN BRIEF ❯ Esri will host a Homeland Security Summit July 9–12 in San Diego aimed at explaining how GIS and related technologies can assist homeland security professionals ❯ DRS Technologies announced its ARMOR X10gx and X7 rugged tablet computers have been certifi ed for connectivity on the Verizon Wireless network ❯ The National Academies Press released a summary of its workshop on Preparedness and Response to a Rural Mass Casualty Incident 22 JULY 2011 | EMSWORLD.com ❯ Eight leading public-safety 9-1-1 vendors will collaborate toward ratifi cation of the National Emergency Number Association i3 document (Functional and Interface Standards for Next Generation 9-1- 1, Standard 08-002 v1 and 08-003 v1) as the sole NG9-1-1 network architecture and interface standard ❯ The Welsh Ambulance Service NHS Trust will equip its front-line ambulances with ZOLL E Series monitor/defi brillators. If you feel tension building in your neck or if you fi nd yourself grinding your teeth, stop and smile. You’ll feel instant relief. Laugh about a ridiculous joke your friend told you. —HealthMad FOR MORE EMS HEALTH TIPS, VISIT EMSWorld.com/toptips years transported to 62 U.S. trauma centers by helicopter or ground ambulance were obtained from the National Sample Program of the 2007 National Trauma Data Bank. In-hospital mortality was calculated for different demographic and injury severity groups. Adjusted odds ratios (AOR) were produced by utilizing a logistic regression model measuring the associa- tion of mortality and type of transport, controlling for age, gender and injury severity (Injury Severity Score [ISS] and Revised Trauma Score [RTS]). Results—The odds of death were 39% lower in those transported by HEMS compared with those trans- ported by ground. Among those aged greater than or equal to 55 years, the odds of death were not signifi cantly different. Among all transports, male patients had a higher odds of death (AOR = 1.23) than female patients. The odds of death increased with each year of age and each unit of ISS, and decreased with each unit of RTS. Conclusion—The use of HEMS for the transport of adult trauma patients was associated with reduced mortality for patients aged 18–54 years. In this study, HEMS did not improve mortality in adults aged greater than or equal to 55 years. Identifi cation of additional By Angelo Salvucci, Jr., MD, FACEP Literature Review: Helicopter Transport and Mortality variables in the selection of those patients who will benefi t from HEMS transport is expected to enhance this reduction in mortality. COMMENT There are differing opinions on the appropriateness of HEMS response and transportation. This study from the Centers for Disease Control and Prevention concludes that trauma patients under the age of 55 were 39% less likely to die of their injuries if transported by HEMS. The reasons are not clear. Shortening the time to defi nitive treatment, especially in areas with sparse ground resources or long distances to a regional trauma center, is one benefi t; equipment and crew exper- tise is another. Future studies will better answer this question. These benefi ts must also be weighed against safety and cost concerns and be put in context of the local EMS system. Abundant ground resources with short transport times would not be circumstances where HEMS would be expected to be helpful. But for the seriously injured patient not close to a trauma center, HEMS appears to have a role in improving patient care. EMS systems should evaluate their protocols with this in mind. Angelo Salvucci, Jr., MD, FACEP, is medical director for the Santa Barbara County and Ventura County (CA) EMS agencies and a member of EMS World Magazine’s editorial advisory board. John Payne

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