Effective transport for trauma patients under current circumstances in Korea: a single institution analysis of treatment outcomes for trauma patients transported via the domestic 119 service.
In Korea, which still lacks a well-established trauma care system, the inability to transport patients to adequate treatment sites in a timely manner is a cause of low trauma patient survival. As such, this study was conducted to serve as a basis for the establishment of a future trauma transport system. We performed a comparative analysis of the transport time, and treatment outcomes between trauma victims transported by ground ambulance (GAMB) and those transported via the helicopter emergency medical service (HEMS) through the National Emergency Management Agency's 119 reporting system, which is similar to the 911 system of the United States, from March 2011 to May 2014. The HEMS-transported patients received treatment instructions, by remote communication, from our trauma specialists from the time of accident reporting; in certain instances, members of the trauma medical staff provided treatment at the scene. A total of 1,626 patients were included in the study; the GAMB and HEMS groups had 1,547 and 79 patients, respectively. The median transport time was different between 2 groups (HEMS, 60 min vs. GAMB, 47 min, P<0.001) but for all patients was 49 min (less than the golden hour). Outcomes were significantly better in the HEMS compared to the GAMB, using the trauma and injury severity score (survival rate, 94.9% vs. 90.5%; Z score, 2.83 vs. -1.96; W score, 6.7 vs. -0.8). A unified 119 service transport system, which includes helicopter transport, and the adoption of a trauma care system that allows active initial involvement of trauma medical personnel, could improve the treatment outcome of trauma patients.
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Jiyoung
0000-0003-4813-1096
J
Kim
Department of Medical Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Korea.
Yunjung
0000-0001-5708-1428
Y
Heo
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
John C J
0000-0002-5468-3340
JC
Lee
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Sukja
0000-0001-5977-6960
S
Baek
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Younghwan
0000-0003-3836-8743
Y
Kim
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Jonghwan
0000-0002-4630-3301
J
Moon
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Seok Hwa
0000-0001-5983-3056
SH
Youn
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Heejung
0000-0002-0687-007X
H
Wang
Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
Yo
0000-0002-1220-1534
Y
Huh
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Kyoungwon
0000-0001-7895-0362
K
Jung
D017732:Air Ambulances / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D011379:Prognosis; D056910:Republic of Korea; D015996:Survival Rate; D013997:Time Factors; D014193:Trauma Centers; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000628:therapy; D014950:Wounds, Penetrating / Q000401:mortality* / Q000628:therapy
Air Ambulances; Outcome; Transfer; Trauma