title: Better trauma care. How Maryland does it.
abstract: In March, 1970, the Maryland State Police, in cooperation with the University of Maryland, started the first statewide airborne transportation system. It was modeled after the army's success in Korea and Vietnam, where battlefield injuries were flown to front-line MASH units. The world's premier statewide medical aviation division was made possible through a cooperative effort between the Maryland State Police Aviation Division and Dr. R Adams Cowley at the University of Maryland Hospital as a public service to the citizens of the state. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) has five components: (1) aircraft, (2) state troopers, (3) system communications (SYSCOM) center, (4) ambulance and fire emergency rescue, and (5) Level I adult and pediatric trauma centers and a regional burn center. The Maryland State Police Aviation Division now has 12 Aerospace Dauphin AS365N helicopters that operate out of eight fixed points throughout the state. Each helicopter has a two-person crew that consists of a pilot and a paramedic. Since 1993, the overall coordination of emergency medical services (EMS) has been under the purview of MIEMSS, an independent executive-level state agency that is governed by an appointed board and advisory council. To ensure stable funding for Maryland's world renowned emergency medical services (EMS) system, including med-evac helicopters, ambulances, fire equipment, rescue squads, and trauma units, a "surcharge" of $13.50 per year is collected with the automobile registration fee where applicable. The SYSCOM center in Baltimore coordinates the helicopter transport to the scene of the accident as well as referral to the specialty care facility: Adult Level I Trauma Center, Pediatric Level I Trauma Center, and Regional Burn Center. An on-the-scene evaluation of this exemplary emergency medical system in Maryland provides further convincing evidence of the performance of the Maryland State Police Aviation Division as they transported an injured child to the Johns Hopkins Pediatric Level I Trauma Center. It is our belief that the model emergency medical system in Maryland, if replicated throughout our nation, would save the lives of the critically injured.
authors.affiliation: Lewis & Clark College, Portland, Oregon, USA. j.wish@comcast.net
authors.forename: John R
authors.initials: JR
authors.lastname: Wish
authors.forename: William B
authors.initials: WB
authors.lastname: Long
authors.forename: Richard F
authors.initials: RF
authors.lastname: Edlich
mesh_terms: D017732:Air Ambulances; D004631:Emergency Medical Service Communication Systems; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D005390:Fires / Q000517:prevention & control; D005392:First Aid; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008396:Maryland; D019982:Organizational Case Studies; D016495:Police; D016730:Program Development; D015397:Program Evaluation; D012307:Risk Factors; D015996:Survival Rate; D017749:Total Quality Management; D014187:Transportation of Patients; D014193:Trauma Centers / Q000458:organization & administration*; D014218:Triage; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*