Comparison of mean on-scene times: road versus air transportation of critically ill patients in the Western Cape of South Africa.
BACKGROUND
The South African setting lends itself to the extensive use of air transport. There is a perception with healthcare providers that flight crews spend too much time with a patient before departure. The main advantage of aero medical transport is to minimise the delay to definitive care and prolonged on-scene time defies this objective. A study was carried out to examine the mean on-scene times of aero medical and road transport of critically ill patients in the Western Cape of South Africa.


METHODS
In this retrospective observational study, all critically ill patients transported in the Western Cape between September 2005 and May 2006 were evaluated. The mean on-scene time for each transport mode was calculated. Road transport was compared with air transport (rotor and fixed wing). Every transport mode was further divided into mission types: "scene" missions (scene to a healthcare facility) or "inter-facility" missions (from one healthcare facility to another).


RESULTS
A total of 7924 transports were included in the study, 7580 of which (95.7%) were road transports. The air transport group spent 53.2 min (95% CI 51.1 to 55.4) at the scene compared with 27.9 min (95% CI 27.5 to 28.4) for the road transport group. There was a significant difference between scene and inter-facility missions in the air transport group (mean 31.7 min for scene missions vs 58.7 min for inter-facility missions; p<0.001). A significant difference was also found in the road transport (mean 24.6 min for scene missions vs 31.9 min for inter-facility missions; p<0.001).


CONCLUSIONS
The on-scene time for transport missions by road is significantly less than for those done by air. There are significant differences between scene and inter-facility missions in both transport modes. Capacity building programmes with ongoing education and training of staff at referring facilities should be implemented.
Van Hoving
D J
DJ
Division of Emergency Medicine, Stellenbosch University/University of Cape Town, South Africa. hoving@lantic.net
Smith
W P
WP
Wallis
L A
LA
D017732:Air Ambulances; D000552:Ambulances; D000704:Analysis of Variance; D016638:Critical Illness; D004632:Emergency Medical Services; D006801:Humans; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D013019:South Africa; D018709:Statistics, Nonparametric; D013997:Time Factors; D013996:Time and Motion Studies