Reduced emergency department stabilization time before cranial computed tomography in patients undergoing air medical transport.
BACKGROUND
Advanced patient stabilization skills provided by air medical providers were hypothesized to result in streamlined emergency department (ED) stabilization of patients with head injuries requiring urgent cranial computed tomography (CCT). The goal of this study was to compare initial ED stabilization times between air- and ground-transported patients requiring urgent CCT and emergency neurosurgical hematoma evacuation.


METHODS
Academic Level trauma center (annual ED census 60,000) receiving patients from ground EMS and a nurse/paramedic air medical transport team.


METHODS
This retrospective study identified, from a database of 15 months of ED visits, consecutive group of adults who had CCT performed within 60 minutes of ED arrival and underwent emergent craniotomy for intracranial hematoma. Demographics, hemodynamic status, patient acuity, and time intervals between ED and CCT suite arrivals were compared between air and ground patients using chi-square, Fisher's exact, and t-tests (p = 0.05).


RESULTS
Eleven air- and 39 ground-transported patients were eligible. All patient acuity data were similar between groups. Air patients were more likely to be intubated (100% versus 71.8%, p = .04) and had shorter mean ED stabilization times (29 versus 40 minutes, p = .02) than the ground.


CONCLUSIONS
This study suggests that advanced patient stabilization offered by air medical transport may result in reduced ED stabilization time for patients requiring urgent craniotomy.
Murphy
M S
MS
Boston MedFlight, Boston, MA 02210, USA.
Thomas
S H
SH
Borczuk
P
P
Wedel
S K
SK
D000046:Academic Medical Centers / Q000458:organization & administration; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017732:Air Ambulances / Q000706:statistics & numerical data*; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging*; D003399:Craniotomy; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013996:Time and Motion Studies; D014057:Tomography, X-Ray Computed; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014481:United States