@article{ref1,
title="Current use and outcomes of helicopter transport in pediatric trauma: a review of 18,291 transports",
journal="Journal of pediatric surgery",
year="2016",
author="Englum, Brian R. and Rialon, Kristy L. and Kim, Jina and Shapiro, Mark L. and Scarborough, John E. and Rice, Henry E. and Adibe, Obinna O. and Tracy, Elisabeth T.",
volume="52",
number="1",
pages="140-144",
abstract="PURPOSE: The role of helicopter emergency medical services (HEMS) in pediatric trauma remains controversial. We examined its use in pediatric trauma and its effectiveness in children with moderate/severe injuries. <br><br>METHODS: All blunt/penetrating trauma patients ≤18years old in the National Trauma Data Bank were evaluated for use of HEMS and in-hospital mortality. In a comparative effectiveness study, only patients treated at level I/II pediatric centers with injury severity score (ISS)≥9 were included. <br><br>RESULTS: Of 127,489 included patients, 18,291 (14%) arrived via HEMS, compared to 56% by ground ambulance and 29% by private vehicle/walk-in. HEMS patients had more severe injuries (ISS≥25; 28% vs. 14%) and altered mental status (GCS≤8; 29% vs. 11%), but also contained many patients with only minor injuries or no major physiologic derangements. In unadjusted analysis, HEMS was associated with increased mortality (OR: 1.6; 95% CI: 1.4-1.7). However, it had decreased mortality by regression (0.5; 0.4-0.6) and propensity analysis (0.7; 0.6-0.8) to adjust for confounders. <br><br>CONCLUSION: We found multiple indicators for overuse of HEMS, with nearly 40% of children having only minor injuries. In moderate/severe injuries, HEMS is associated with decreased mortality, potentially saving one life for every 47 flights. Research is needed to determine appropriate criteria for helicopter triage. COMPARATIVE STUDY/LEVEL OF EVIDENCE: III.<br><br>Copyright © 2016. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2016.10.030",
url="http://dx.doi.org/10.1016/j.jpedsurg.2016.10.030"
}