Transport of winter resort injuries to regional trauma centers

Introduction: This study examined the epidemiology of winter resort injuries presenting to regional trauma centers by helicopter (HEMS) or ground (GEMS) ambulance.

Methods: Five hundred seventy-five patients (GEMS 289; HEMS 286) were identified from trauma registries and HEMS transport records. Demographic data, hospital interventions, and discharge status were examined.

Results: HEMS patients had a significantly lower Glasgow coma score (GCS) and trauma score (TS), longer intensive care unit (ICU) length of stay (LOS), and more deaths than did GEMS patients (P < 0.05). Despite this, significantly more HEMS patients were discharged home from the emergency department (24.5% vs. 4.8%; P < 0.001). HEMS patients had more isolated head/facial injuries and multiple injuries, with less isolated extremity injuries than did GEMS patients (P < 0.05). Regardless of transport mode, patients with multiple injuries, thoracoabdominal injuries, or head injuries with a GCS ≤ 13 were more likely to require immediate interventions (intubation, chest tube, blood products). Patients with isolated extremity injuries rarely needed immediate care.

Conclusion: HEMS patients had a higher acuity and different injury pattern when compared to GEMS patients. Approximately 24.5% of HEMS patients were discharged home from the ED. This reflects significant overtriage of patients to HEMS. A prospective study examining the initial triage of patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.