title: Transport of winter resort injuries to regional trauma centers.
abstract: BACKGROUND
  This study examined the epidemiology of winter resort injuries presenting to regional trauma centers by helicopter (HEMS) or ground (GEMS) ambulance.
  
  
  METHODS
  Five hundred seventy-five patients (GEMS 289; HEMS 286) were identified from trauma registries and HEMS transport records. Demographic data, hospital interventions, and discharge status were examined.
  
  
  RESULTS
  HEMS patients had a significantly lower Glasgow coma score (GCS) and trauma score (TS), longer intensive care unit (ICU) length of stay (LOS), and more deaths than did GEMS patients (P < 0.05). Despite this, significantly more HEMS patients were discharged home from the emergency department (24.5% vs. 4.8%; P < 0.001). HEMS patients had more isolated head/facial injuries and multiple injuries, with less isolated extremity injuries than did GEMS patients (P < 0.05). Regardless of transport mode, patients with multiple injuries, thoracoabdominal injuries, or head injuries with a GCS < or = 13 were more likely to require immediate interventions (intubation, chest tube, blood products). Patients with isolated extremity injuries rarely needed immediate care.
  
  
  CONCLUSIONS
  HEMS patients had a higher acuity and different injury pattern when compared to GEMS patients. Approximately 24.5% of HEMS patients were discharged home from the ED. This reflects significant overtriage of patients to HEMS. A prospective study examining the initial triage of patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.
authors.affiliation: Emergency Department Clinical Operations, University of Utah Health Sciences Center, Salt Lake City, Utah 84143, USA. Christy.mccowan@hsc.utah.edu
authors.forename: Christy L
authors.initials: CL
authors.lastname: McCowan
authors.forename: Frank
authors.initials: F
authors.lastname: Thomas
authors.forename: Eric R
authors.initials: ER
authors.lastname: Swanson
authors.forename: Stephen
authors.initials: S
authors.lastname: Hartsell
authors.forename: Janet
authors.initials: J
authors.lastname: Cortez
authors.forename: Sue
authors.initials: S
authors.lastname: Day
authors.forename: Diana L
authors.initials: DL
authors.lastname: Handrahan
mesh_terms: D000293:Adolescent; D000328:Adult; D017732:Air Ambulances; D003080:Cold Temperature; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D014187:Transportation of Patients; D014589:Utah / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology*