TY  - JOUR
PY  - 2016//
TI  - Current use and outcomes of helicopter transport in pediatric trauma: a review of 18,291 transports
JO  - Journal of pediatric surgery
A1  - Englum, Brian R.
A1  - Rialon, Kristy L.
A1  - Kim, Jina
A1  - Shapiro, Mark L.
A1  - Scarborough, John E.
A1  - Rice, Henry E.
A1  - Adibe, Obinna O.
A1  - Tracy, Elisabeth T.
SP  - 140
EP  - 144
VL  - 52
IS  - 1
N2  - 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>
LA  - en
SN  - 0022-3468
UR  - http://dx.doi.org/10.1016/j.jpedsurg.2016.10.030
ID  - ref1
ER  -