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  • Title: Scene transport of pediatric patients injured at winter resorts.
    Author: McCowan CL, Swanson ER, Thomas F, Hartsell S, Allen TL, Handrahan DL, Kwok K.
    Journal: Prehosp Emerg Care; 2006; 10(1):35-40. PubMed ID: 16418089.
    Abstract:
    OBJECTIVE: To examine the characteristics of pediatric patients (age =16 years) injured at winter resort scenes and transported by helicopter emergency medical services (HEMS) or ground EMS (GEMS) ambulance services to regional trauma centers. METHODS: Between 1997 and 2001, a total of 119 patients (GEMS = 69; HEMS = 50) were identified from trauma registries and HEMS transport records. Demographic data, initial vital signs, hospital interventions, and discharge status of the two groups were examined. RESULTS: The distributions of gender, initial vital signs, Injury Severity Score (ISS; either = or > 15), intensive care unit (ICU) length of stay (LOS), total hospital LOS, and home discharge status were similar between the two groups (p = 0.05). Patients transported by HEMS were older (14 +/- 2 vs. 10 +/- 4, p < 0.001), less likely to be admitted to the hospital (73% vs. 98.5%; p < 0.001), and more likely to have multiple injuries [13 (27%) vs. 8 (11.6%), p = 0.032]. The GEMS patients had a higher rate of isolated extremity [33 (80.5%) vs. 8 (19.5%)] and thoracoabdominal [11 (73.3%) vs. 4 (26.7%)] injuries. The high orthopedic injury rate in the GEMS patients contributed to a higher rate of surgery in this group (45% vs. 24%, p = 0.028). Regardless of transport mode, patients requiring immediate interventions (intubation, chest tube placement, or blood product administration) had either a depressed level of consciousness (GCS = 12) on emergency department arrival or thoracoabdominal injuries. No deaths were recorded. CONCLUSIONS: Patients transported by HEMS and GEMS had similar hospital characteristics but different injury patterns. A prospective study examining the initial triage of pediatric patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.
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