title: Impact of introducing a major trauma network on a regional helicopter emergency medicine service in the UK.
abstract: BACKGROUND
  In the West Midlands region of the UK, the delivery of prehospital trauma care has recently been remodelled through the introduction of a regionalised major trauma network (MTN). Helicopter emergency medical services (HEMS) are integral to the network, providing means of delivering highly skilled specialist teams to scenes of trauma and rapid transfer of patients to major trauma centres. This study reviews the impact of introducing the West Midlands MTN on the operation of one its regional HEMS units.
  
  
  METHODS
  Retrospective review of the Midlands Air Ambulance clinical database for the 6 months after the launch of the West Midlands MTN. The corresponding period for the previous year was reviewed for comparison. The contribution of trauma cases to overall workload, mission outcome data and the number of interventions performed at the scene were compared.
  
  
  RESULTS
  The proportion of HEMS activations for trauma cases was similar in both cohorts (70.84% before MTN vs 71.57% after MTN). The proportion of mission cancellations was significantly lower after the launch of the network (23.71% vs 19.03%). Significantly more scene attendances resulted in interventions by HEMS crews after the MTN launch (44.66% vs 56.92%).
  
  
  CONCLUSIONS
  Since the introduction of the West Midlands MTN, tasking of HEMS assets appears to be better targeted to cases involving significant injury, and a reduction in mission cancellations has been observed. There is a need for more detailed evaluation of patient outcomes to identify strategies for optimising the utilisation of HEMS assets within the regional network.
authors.affiliation: Academic Department of Anaesthesia, Critical Care, Pain & Resuscitation, Birmingham Heartlands Hospital, Birmingham, West Midlands, UK Midlands Air Ambulance, Unit 16 Enterprise Trading Estate, Birmingham, West Midlands, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: McQueen
authors.affiliation: Midlands Air Ambulance, Unit 16 Enterprise Trading Estate, Birmingham, West Midlands, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Crombie
authors.affiliation: Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK.
authors.forename: Gavin D
authors.initials: GD
authors.lastname: Perkins
authors.affiliation: West Midlands Ambulance Service NHS Foundation Trust, Birmingham, West Midlands, UK.
authors.forename: Steve
authors.initials: S
authors.lastname: Wheaton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017732:Air Ambulances / Q000706:statistics & numerical data*; D002648:Child; D004632:Emergency Medical Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000628:therapy*; D012189:Retrospective Studies; D006113:United Kingdom; D055815:Young Adult
keywords: Major Trauma Management; Prehospital Care, Despatch; Prehospital Care, Helicopter Retrieval; Trauma, Research