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Air Med J. 2019 Jul - Aug;38(4):289-293. doi: 10.1016/j.amj.2019.04.003. Epub 2019 May 23.

A Physician-Based Helicopter Emergency Medical Services Was Associated With an Additional 2.5 Lives Saved per 100 Dispatches of Severely Injured Pediatric Patients.

Author information

1
Department of Anesthesiology, Erasmus MC, University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands. Electronic address: x.moors@erasmusmc.nl.
2
Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
3
Department of Anesthesiology, Erasmus MC, University Medical Center-Sophia Children's Hospital, Rotterdam, the Netherlands.

Abstract

OBJECTIVE:

Physician-based helicopter emergency medical services (HEMS) provide specialist medical care to the accident scene in order to improve the survival of severely injured patients. Studies that focus on the role of physician-based HEMS in pediatric trauma are scarce. The aim of this retrospective, observational study was to determine the effect of physician-based HEMS assistance on the survival of severely injured pediatric patients.

METHODS:

All consecutive severely injured pediatric patients (age < 18 years and Injury Severity Score > 15) treated between October 1, 2000, and February 28, 2013, were included. The survival of patients who received medical care of physician-based HEMS was compared with the survival of patients treated by an ambulance paramedic crew (ie, emergency medical services group) only. A regression model was developed for calculating the survival benefit in the physician-based HEMS group.

RESULTS:

A total of 308 patients were included; 112 (36%) were primarily treated by emergency medical services, and 196 (64%) patients received additional physician-based HEMS assistance on scene. The model with the best diagnostic properties and fit contained physician-based HEMS assistance, 3 components of the Glasgow Coma Scale (eye, motor, and verbal) scored prehospitally (before intubation), ordinal values for the Injury Severity Scale, systolic blood pressure, and respiratory rate. This model predicted that 5 additional patients survived because of physician-based HEMS assistance. This corresponds with 2.5 additional lives saved per 100 physician-based HEMS dispatches for severely injured pediatric patients.

CONCLUSION:

The data suggest that an additional 2.5 lives might be saved per 100 physician-based HEMS dispatches for severely injured pediatric patients.

PMID:
31248540
DOI:
10.1016/j.amj.2019.04.003

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