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Tue May 1 17:31:16 BST 2007

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of KMATTOX at aol.com
Sent: Tuesday, May 01, 2007 12:01 PM
To: trauma-list at trauma.org
Subject: TIME - Air Ambulance Issues (formerly .......)

"Show me  a paper that has data that air transport improves outcome in
the US. Every  one that I've seen shows no outcome difference. It's
amazing how fast  people ignore data when it goes against their biases."

"You have seen the same papers that I have seen.  I have really really
looked hard for the kind of paper that you are requesting.  The ONLY
papers I can find (more than 700 in my files on air ambulances) are
those from the military..."

Dr. Mattox:

Via PubMed: ten minutes, ten papers.  If you can't find data, you're not
looking very hard.  

Admittedly, research into helicopter EMS suffers for small numbers and
high variability (patients, vehicles, providers, systems...), but to say
there's no data is a glib antifact.

...

Frink M, et al.  The influence of transportation mode on mortality in
polytraumatized patients : An analysis based on the German Trauma
Registry.  Unfallchirurg [German]. 2007 Apr;110(4):334-340.
CONCLUSION: According to our analysis of the German Trauma Registry,
patients with multiple injuries benefit from [Helicopter EMS]
transportation.

Davis, DP et al.  The impact of aeromedical response to patients with
moderate to severe traumatic brain injury.  Ann Emerg Med. 2005
Aug;46(2):115-22.
CONCLUSION: Aeromedical response appears to result in improved outcomes
after adjustment for multiple influential factors in patients with
moderate to severe traumatic brain injury.

Frankema SP, et al.  Beneficial effect of helicopter emergency medical
services on survival of severely injured patients.  Br J Surg. 2004
Nov;91(11):1520-6.
CONCLUSION: The presence of the HMT may increase chances of survival for
patients suffering multiple trauma, especially for those with blunt
trauma.

Biewener A, et al.  Impact of helicopter transport and hospital level on
mortality of polytrauma patients.  J Trauma. 2004 Jan;56(1):94-8.
CONCLUSION: Primary transfer by HEMS into a Level I trauma center
reduces mortality markedly. In principle, this benefit can be attributed
to superior preclinical therapy, primary admission to a Level I trauma
center, or both. However, the identical probability of survival of the
AMB-UNI and HEMS-UNI groups in this and comparable studies does not
confirm generally better survival rates on account of a more aggressive
on-site approach.

Buntman AJ, Yeomans KA.  The effect of air medical transport on survival
after trauma in Johannesburg, South Africa.  S Afr Med J. 2002
Oct;92(10):807-11.
CONCLUSION: Patients with a certain injury severity are more likely to
survive if transported by air to a trauma unit.

Thomas SH, et al.  Helicopter transport and blunt trauma mortality: a
multicenter trial.  J Trauma. 2002 Jan;52(1):136-45.
CONCLUSION: The results of this study are consistent with an association
between helicopter transport mode and increased survival in blunt trauma
patients.

Cummings G, O'Keefe G.  Scene disposition and mode of transport
following rural trauma: a prospective cohort study comparing patient
costs.  J Emerg Med. 2000 Apr;18(3):349-54.
CONCLUSION: Since no significant difference in prehospital helicopter
and ground transport costs was demonstrated, the decision on mode of
transport should be in the best interest of patient care.

Jacobs LM, et al.  Helicopter air medical transport: ten-year outcomes
for trauma patients in a New England program.  Conn Med. 1999
Nov;63(11):677-82.
CONCLUSION: Rapid utilization of helicopter air medical transport can
have a dramatic impact upon patient outcome, especially within a select
group of scene transported trauma patients with Trauma Scores ranging
from four to 13.

Kerr WA, et al.  Differences in mortality rates among trauma patients
transported by helicopter and ambulance in Maryland.  Prehospital
Disaster Med. 1999 Jul-Sep;14(3):159-64.
CONCLUSION: This study suggests the rapid air transport of victims of
traumatic events by specialized personnel in Maryland has a positive
effect on the outcome of severely injured patients.

Falcone RE, et al.  Air medical transport of the injured patient: scene
versus referring hospital.  Air Med J. 1998 Oct-Dec;17(4):161-5.  
CONCLUSION: Patients transferred from a referring hospital took almost
six times longer to reach definitive care and may have suffered an
increased morbidity and mortality on this basis.

Pret

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