Effect of physician-staffed helicopter emergency medical service on blunt trauma patient survival and prehospital care.
OBJECTIVE
The aim of the study was to assess the immediate and long-term effect of a helicopter emergency physician giving advanced life support on-scene compared with conventional load and go principle in urban and rural settings in treating blunt trauma patients.


METHODS
In a retrospective study, 81 blunt trauma patients treated prehospitally by a physician-staffed helicopter emergency medical service were compared with 77 patients treated before the era of the helicopter emergency medical service. The data were collected in the prehospital and hospital files and a questionnaire was sent to the survivors 3 years after the trauma.


RESULTS
The physicians treated the patients more aggressively (gave drugs, intubated and cannulated) and had the patients transported directly to a university hospital. The given treatment did not delay arrival at the hospital. No statistically significant difference was found, but a trend (P = 0.065) to lower survival in the helicopter emergency medical service group. Almost half of the deaths in the helicopter emergency medical service group and none in the control group, however, occurred in the emergency department. No difference was found 3 years later between the groups in the health-related quality of life or decrease in the income owing to the accident.


CONCLUSIONS
The physicians treated the patients more aggressively, but it did not delay the arrival at the hospital. A beneficial effect of this aggressive treatment or direct transport to a university hospital could not be seen in the immediate physiological parameters or later health-related quality of life. The physician-staffed helicopter emergency medical service was not beneficial to blunt trauma patients in this setting.
Iirola
Timo T
TT
Department of Anaesthesia and Intensive Care, Turku University Hospital, University of Turku, Turku, Finland. tiirola@iki.fi
Laaksonen
Mikko I
MI
Vahlberg
Tero J
TJ
Pälve
Heikki K
HK
D000328:Adult; D022561:Advanced Cardiac Life Support / Q000379:methods / Q000706:statistics & numerical data; D017732:Air Ambulances; D001294:Attitude to Health; D004632:Emergency Medical Services / Q000379:methods; D005260:Female; D005387:Finland / Q000453:epidemiology; D006302:Health Services Research; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008503:Medical Staff / Q000600:supply & distribution*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D015397:Program Evaluation; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017741:Survivors / Q000523:psychology; D013997:Time Factors; D014187:Transportation of Patients; D000078329:Workforce; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000523:psychology / Q000628:therapy*