Benefits and risks of helicopter transport for trauma patients investigated
Research Activities, August 2012, No. 384
Helicopters have been used to transport trauma patients since 1972. Debate continues as to whether they improve patient outcomes. Concerns have also been raised about patient and crew safety, owing to a number of high-profile crashes. A recent review of studies in the literature suggests that helicopter emergency medical service (HEMS) does reduce deaths among certain subgroups of trauma patients. However, more strict, evidence-based criteria are needed to determine who is likely to benefit from HEMS transport.
Published studies have produced varied findings regarding improved mortality and the benefits of ground versus air transport. HEMS appears to be most beneficial for patients with severe injuries aged 18-54. The majority of studies do find that HEMS is cost-effective when it comes to cost per life-year, per life saved, and per quality-adjusted life-year. However, trauma systems vary widely in their design and implementation, so HEMS may not be cost-effective for all systems.
The rate of fatal crashes is higher than in all other sectors of aviation. As a result, HEMS must be used judiciously in order to maximize patient survival outcomes and minimize crash risk to those onboard. Given all of these findings, strict, validated triage criteria need to be developed that will assist emergency medical services personnel on the ground if HEMS transport is necessary. This is best determined at the local level with further studies needed to create optimal approaches that are cost-effective, safe, and efficacious, conclude the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS19482).
See "Helicopter transport: help or hindrance?" by Rebecca E. Plevin, M.D. and Heather L. Evans, M.D., M.S., in Current Opinions in Critical Care 17, pp. 596-600, 2011.