This paper is only available as a PDF. To read, Please Download here.
Objectives
Efforts to identify which patients benefit most from Helicopter Emergency Services
(HEMS) activation can help guide clinical decisions around employing this costly and
often risky resource. This scoping review seeks to identify trends in survival outcomes
data comparing helicopter and ground emergency services (GEMS) transports directly
from trauma scenes to definitive care, critically assess the quality of existing data,
and generate questions for further directed study.
Methods
Pubmed was the primary database used for this review. Database search was conducted
by a matrix approach utilizing MeSH search terms as well as general keyword search
criteria. Included studies were published in 2010 or later and directly compared survival
in HEMS and GEMS trauma transports from scene. Studies were evaluated by 3 independent
reviewers to ensure inclusion criteria were met.
Results
Forty-one retrospective cohort studies were included for review. HEMS and GEMS survival
outcomes were compared overall or based on patient physiologic criteria, injury type,
injury severity, and patient age. HEMS activation was associated with improved survival
overall in both nation-wide and single-institution studies. When comparing HEMS and
GEMS survival based on type of injury, results were mixed with the exception of traumatic
brain injury which benefited from HEMS activation across several studies. When patient
characteristics were compared, those with unstable vital signs at the trauma scene
appeared to benefit from HEMS activation. Patient age (pediatrics patients or those
>55 years) was not consistently associated with mortality benefit.
Conclusions
After controlling for injury severity and patient characteristics, HEMS is associated
with improved survival in patients transported from trauma scenes. Several studies
reported that patients with unstable vital signs on scene and those with traumatic
brain injuries benefit most from HEMS activation. The quality of the existing evidence
is poor, in large part due to methodological limitations and confounding variables
that cannot be controlled for on a trauma scene. Further study is needed to elucidate
specific factors that lead to the possible survival benefit of HEMS.
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 accessOne-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 JournalAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
Article info
Identification
Copyright
© 2022 Published by Elsevier Inc.
