title: Scene transport of pediatric patients injured at winter resorts.
abstract: OBJECTIVE
  To examine the characteristics of pediatric patients (age =16 years) injured at winter resort scenes and transported by helicopter emergency medical services (HEMS) or ground EMS (GEMS) ambulance services to regional trauma centers.
  
  
  METHODS
  Between 1997 and 2001, a total of 119 patients (GEMS = 69; HEMS = 50) were identified from trauma registries and HEMS transport records. Demographic data, initial vital signs, hospital interventions, and discharge status of the two groups were examined.
  
  
  RESULTS
  The distributions of gender, initial vital signs, Injury Severity Score (ISS; either = or > 15), intensive care unit (ICU) length of stay (LOS), total hospital LOS, and home discharge status were similar between the two groups (p = 0.05). Patients transported by HEMS were older (14 +/- 2 vs. 10 +/- 4, p < 0.001), less likely to be admitted to the hospital (73% vs. 98.5%; p < 0.001), and more likely to have multiple injuries [13 (27%) vs. 8 (11.6%), p = 0.032]. The GEMS patients had a higher rate of isolated extremity [33 (80.5%) vs. 8 (19.5%)] and thoracoabdominal [11 (73.3%) vs. 4 (26.7%)] injuries. The high orthopedic injury rate in the GEMS patients contributed to a higher rate of surgery in this group (45% vs. 24%, p = 0.028). Regardless of transport mode, patients requiring immediate interventions (intubation, chest tube placement, or blood product administration) had either a depressed level of consciousness (GCS = 12) on emergency department arrival or thoracoabdominal injuries. No deaths were recorded.
  
  
  CONCLUSIONS
  Patients transported by HEMS and GEMS had similar hospital characteristics but different injury patterns. A prospective study examining the initial triage of pediatric patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.
authors.affiliation: Emergency Department, LDS Hospital, Salt Lake City, UT 84132, USA. Christy.McCowan@hsc.utah.edu
authors.forename: Christy L
authors.initials: CL
authors.lastname: McCowan
authors.forename: Eric R
authors.initials: ER
authors.lastname: Swanson
authors.forename: Frank
authors.initials: F
authors.lastname: Thomas
authors.forename: Stephen
authors.initials: S
authors.lastname: Hartsell
authors.forename: Todd L
authors.initials: TL
authors.lastname: Allen
authors.forename: Diana L
authors.initials: DL
authors.lastname: Handrahan
authors.forename: Kelli
authors.initials: K
authors.lastname: Kwok
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D017732:Air Ambulances / Q000706:statistics & numerical data; D001265:Athletic Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D017678:Sex Distribution; D012865:Skiing / Q000293:injuries*; D014187:Transportation of Patients / Q000706:statistics & numerical data*; D014589:Utah / Q000453:epidemiology