Helicopter transport of pediatric trauma patients in an urban emergency medical services system: a critical analysis.
BACKGROUND
Helicopter transport of pediatric trauma patients in an urban Emergency Medical Services system remains controversial.


METHODS
A retrospective review of pediatric patients transported by helicopter to a pediatric trauma center in Los Angeles, California, was conducted over a 3-year period. Pediatric patients (age < 15 years) are transported by helicopter if ground transport to a pediatric trauma center would exceed 20 minutes. Emergency Medical Services reports and hospital records were reviewed for key prehospital and outcome indicators.


RESULTS
One hundred eighty-nine patients met the study inclusion criteria. The median age was 5 years (range, 0-14 years). The most common mechanisms of injury were falls and automobile versus pedestrian crashes. Eighty-two percent of patients had a Revised Trauma Score > 7. Of the 175 (93%) patients whose hospital records were available, 24 (14%) were intubated in the emergency department, 32 (18%) were admitted to the intensive care unit, and 7 (4%) were taken directly to the operating room. Injury Severity Scores (ISSs) were as follows: ISS 0 to 15, 146 (83%); ISS 16 to 30, 26 (15%); and ISS > 30, 3 (2%). Fifty-seven (33%) patients were discharged home from the emergency department.


CONCLUSIONS
The majority of pediatric trauma patients transported by helicopter in our study sustained minor injuries. A revised policy to better identify pediatric patients who might benefit from helicopter transport appears to be warranted.
Eckstein
Marc
M
Department of Emergency Medicine, University of Southern California School of Medicine, Los Angeles, California, USA. eckstein@hsc.usc.edu
Jantos
Thomas
T
Kelly
Nicole
N
Cardillo
Anthony
A
D000293:Adolescent; D017732:Air Ambulances / Q000191:economics / Q000706:statistics & numerical data; D000704:Analysis of Variance; D002648:Child; D002662:Child Health Services / Q000191:economics; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D006300:Health Services Misuse; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D015141:Los Angeles; D012189:Retrospective Studies; D014218:Triage; D014600:Utilization Review; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000628:therapy*