EMS and emergency department physician triage: injury severity in trauma patients transported by helicopter.
BACKGROUND
Many trauma patients who are not severely injured arrive at trauma centers via helicopter emergency medical services (HEMS).


OBJECTIVE
To compare the injury severity of patients sent to trauma centers by HEMS from community emergency departments (EDs) with the injury severity of those triaged by prehospital providers to HEMS directly from accident scenes.


METHODS
All records were reviewed from trauma-related missions during 1997for a single HEMS system, extracting information on location, time of day, patient age and gender, mechanism of injury, initial vital signs, Revised Trauma Score (RTS), and the extent of care required during transport. These records were then matched with outcome information routinely supplied to the HEMS system by affiliated trauma centers. Information from patients flown directly from scenes was then compared with that for patients flown from community EDs.


RESULTS
Information was obtained for 658 patients flown from scenes and 345 flown from community EDs. There were similar proportions of patients in the two groups, with Injury Severity Scale (ISS) scores less than 6 (11.0% vs. 13.5%), between 6 and 14 (47.0% vs. 49.3%), and greater than 15 (42.0% vs. 37.1%); these were not statistically different (p > 0.05). There was also no significant difference between the groups in the RTS, mean ISS score, intensive care unit length of stay, hospital length of stay, or disposition.


CONCLUSIONS
Scene and interhospital HEMS trauma missions in this system involve patients of similar injury severities. Prehospital providers may triage trauma patients to HEMS transport with proficiency similar to that of community ED physicians.
Lubin
Jeffrey S
JS
Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA. jeffrey.lubin@uhhs.com
Delbridge
Theodore R
TR
Cole
John S
JS
Nicholas
Dederia H
DH
Fore
Christopher A
CA
Wadas
Richard J
RJ
D017732:Air Ambulances / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D004635:Emergency Medicine / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D009820:Ohio; D010414:Pennsylvania; D014218:Triage / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000175:diagnosis*