Advertisement
Original Research| Volume 25, ISSUE 1, P26-34, January 2006

Download started.

Ok

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.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Air Medical Journal
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Levy AS
        • Smith RH
        Neurologic injuries in skiers and snowboarders.
        Semin Neurol. 2000; 20: 233-245
        • Levy AS
        • Hawkes AP
        • Hemminger LM
        • Knight S
        An analysis of head injuries among skiers and snowboarders.
        J Trauma. 2002; 53: 695-704
        • Tarazi F
        • Dvorak MF
        • Wing PC
        Spinal injuries in skiers and snowboarders.
        Am J Sports Med. 1999; 27: 177-180
        • Koehle MS
        • Lloyd-Smith R
        • Taunton JE
        Alpine ski injuries and their prevention.
        Sports Med. 2002; 32: 785-793
        • Johnson RJ
        • Ettlinger CF
        • Campbell RJ
        • Pope MH
        Trends in skiing injuries. Analysis of a 6-year study (1972 to 1978).
        Am J Sports Med. 1980; 8: 106-113
        • Furrer M
        • Erhart S
        • Frutiger A
        • Bereiter H
        • Leutenegger A
        • Ruedi T
        Severe skiing injuries: a retrospective analysis of 361 patients including mechanism of trauma, severity of injury, and mortality.
        J Trauma. 1995; 39: 737-741
        • Jurkovich GJ
        • Pearce WH
        • Cleveland HC
        Thoracic and abdominal injuries in skiers: the role of air evacuation.
        J Trauma. 1983; 23: 844-848
        • Johnson RJ
        • Pope MH
        • Ettlinger C
        Ski injuries and equipment function.
        J Sports Med. 1974; 2: 299-307
        • Ellison AE
        Skiing injuries.
        Clin Symp. 1977; 29: 1-40
        • Warme WJ
        • Feagin Jr., JA
        • King P
        • Lambert KL
        • Cunningham RR
        Ski injury statistics, 1982 to 1993, Jackson Hole Ski Resort.
        Am J Sports Med. 1995; 23: 597-600
        • Deibert MC
        • Aronsson DD
        • Johnson RJ
        • Ettlinger CF
        • Shealy JE
        Skiing injuries in children, adolescents, and adults.
        J Bone Joint Surg Am. 1998; 80: 25-32
        • Ettlinger CF
        • Johnson RJ
        • Shealy JE
        A method to help reduce the risk of serious knee sprains incurred in alpine skiing.
        Am J Sports Med. 1995; 23: 531-537
        • Xiang H
        • Stallones L
        Deaths associated with snow skiing in Colorado 1980-1981 to 2000-2001 ski seasons.
        Injury. 2003; 34: 892-896
        • Machida T
        • Hanazaki K
        • Ishizaka K
        • Nakamura M
        • Kobayashi O
        • Shibata H
        • et al.
        Snowboarding injuries of the abdomen: comparison with skiing injuries.
        Injury. 1999; 30: 47-49
        • Machida T
        • Hanazaki K
        • Ishizaka K
        • Nakamura M
        • Kobayashi O
        • Shibata H
        • et al.
        Snowboarding injuries of the chest: comparison with skiing injuries.
        J Trauma. 1999; 46: 1062-1065