Adopting the pre-hospital index for interfacility helicopter transport: a proposal.
BACKGROUND
Interfacility helicopter transport is expensive without proven outcome benefit in trauma patients. Our objectives were to determine the fastest method of rural to urban interfacility transport, and develop a triage tool to identify patients most in need of rapid transport.


METHODS
Retrospective cohort study. Adults ISS > or = 12 transported from January 1996 to December 1998. Transport time variables were compared between geographical zones. A pre-transport index (PTI) identified two patient cohorts in which outcome was assessed.


RESULTS
Air ambulance was faster than ground transport, with helicopter overall superior to fixed-wing (< 225 km range). Seventy-two percent of patients with PTI < 4 (n = 196) had no outcome indicating severe injury versus 29% of the PTI > or = 4 cohort (n=151). Mortality for PTI<4 was 1.4% versus 22% for PTI > or = 4.


CONCLUSIONS
Interfacility helicopter transport of severely injured rural trauma patients was the overall fastest method within a 225 km range. PTI > 4 identifies patients most in need of this fast but expensive method of transport.
Goldstein
Leanelle
L
Division of Critical Care, Department of Surgery, Trauma Services, Foothills Medical Centre, University of Calgary, 1403-29 Street NW, Calgary, Alta., Canada T2N 2T9.
Doig
Christopher J
CJ
Bates
Sarah
S
Rink
Sandra
S
Kortbeek
John B
JB
D000328:Adult; D017732:Air Ambulances / Q000191:economics* / Q000706:statistics & numerical data; D000552:Ambulances / Q000191:economics / Q000706:statistics & numerical data; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010360:Patient Transfer / Q000191:economics* / Q000379:methods; D012189:Retrospective Studies; D019035:Rural Health Services; D013996:Time and Motion Studies; D015599:Trauma Severity Indices; D014218:Triage / Q000379:methods*; D014481:United States; D019037:Urban Health Services; D014947:Wounds and Injuries