Analysis of Transport to an American College of Surgeons Level I Trauma Center

Daniel Hakakian, Karen Kong, Dorian Atanas Bogdanovski, Andrew Benvenuto, Louis Thomas DiFazio, Renay Durling-Grover, Rolando Rolandelli, Zoltan H. Nemeth

Research output: Contribution to journalArticle

Abstract

Introduction: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. Setting: Morristown Medical Center (MMC), Morristown, NJ Methods: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed. Results: 22% of admissions were HEMS and 78% were GEMS. HEMS patients had higher Injury Severity Scores (ISS) (p<0.001); however, mortality and length of stay were not statistically different. The percentage of pediatric patients transported by HEMS that were discharged home after emergency department evaluation was greater than the older populations (p<0.001). Older age and higher ISS had the largest impact on mortality (p<0.001). Conclusion: We believe our current use of HEMS is adequate since patient outcomes between HEMS and GEMS was similar, even though HEMS patients have higher ISS. However, helicopter use in the pediatric population was over-utilized, possibly due to the scarcity of hospitals capable of managing pediatric traumas. Implementation of the Air Medical Prehospital Triage scoring system may also help correct for these unnecessary HEMS transports.

Original languageEnglish (US)
Pages (from-to)95-99
Number of pages5
JournalAir Medical Journal
Volume38
Issue number2
DOIs
StatePublished - Mar 1 2019
Externally publishedYes

Fingerprint

Trauma Centers
Emergency Medical Services
Aircraft
Injury Severity Score
Pediatrics
Wounds and Injuries
Transportation of Patients
Mortality
Triage
Population
Hospital Emergency Service
Length of Stay
Air
Demography

All Science Journal Classification (ASJC) codes

  • Emergency Medicine
  • Emergency

Cite this

Hakakian, D., Kong, K., Bogdanovski, D. A., Benvenuto, A., DiFazio, L. T., Durling-Grover, R., ... Nemeth, Z. H. (2019). Analysis of Transport to an American College of Surgeons Level I Trauma Center. Air Medical Journal, 38(2), 95-99. https://doi.org/10.1016/j.amj.2018.11.013
Hakakian, Daniel ; Kong, Karen ; Bogdanovski, Dorian Atanas ; Benvenuto, Andrew ; DiFazio, Louis Thomas ; Durling-Grover, Renay ; Rolandelli, Rolando ; Nemeth, Zoltan H. / Analysis of Transport to an American College of Surgeons Level I Trauma Center. In: Air Medical Journal. 2019 ; Vol. 38, No. 2. pp. 95-99.
@article{7b66282284d249e1a25ec6b910158142,
title = "Analysis of Transport to an American College of Surgeons Level I Trauma Center",
abstract = "Introduction: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. Setting: Morristown Medical Center (MMC), Morristown, NJ Methods: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed. Results: 22{\%} of admissions were HEMS and 78{\%} were GEMS. HEMS patients had higher Injury Severity Scores (ISS) (p<0.001); however, mortality and length of stay were not statistically different. The percentage of pediatric patients transported by HEMS that were discharged home after emergency department evaluation was greater than the older populations (p<0.001). Older age and higher ISS had the largest impact on mortality (p<0.001). Conclusion: We believe our current use of HEMS is adequate since patient outcomes between HEMS and GEMS was similar, even though HEMS patients have higher ISS. However, helicopter use in the pediatric population was over-utilized, possibly due to the scarcity of hospitals capable of managing pediatric traumas. Implementation of the Air Medical Prehospital Triage scoring system may also help correct for these unnecessary HEMS transports.",
author = "Daniel Hakakian and Karen Kong and Bogdanovski, {Dorian Atanas} and Andrew Benvenuto and DiFazio, {Louis Thomas} and Renay Durling-Grover and Rolando Rolandelli and Nemeth, {Zoltan H.}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.amj.2018.11.013",
language = "English (US)",
volume = "38",
pages = "95--99",
journal = "Air Medical Journal",
issn = "1067-991X",
publisher = "Mosby Inc.",
number = "2",

}

Hakakian, D, Kong, K, Bogdanovski, DA, Benvenuto, A, DiFazio, LT, Durling-Grover, R, Rolandelli, R & Nemeth, ZH 2019, 'Analysis of Transport to an American College of Surgeons Level I Trauma Center', Air Medical Journal, vol. 38, no. 2, pp. 95-99. https://doi.org/10.1016/j.amj.2018.11.013

Analysis of Transport to an American College of Surgeons Level I Trauma Center. / Hakakian, Daniel; Kong, Karen; Bogdanovski, Dorian Atanas; Benvenuto, Andrew; DiFazio, Louis Thomas; Durling-Grover, Renay; Rolandelli, Rolando; Nemeth, Zoltan H.

In: Air Medical Journal, Vol. 38, No. 2, 01.03.2019, p. 95-99.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analysis of Transport to an American College of Surgeons Level I Trauma Center

AU - Hakakian, Daniel

AU - Kong, Karen

AU - Bogdanovski, Dorian Atanas

AU - Benvenuto, Andrew

AU - DiFazio, Louis Thomas

AU - Durling-Grover, Renay

AU - Rolandelli, Rolando

AU - Nemeth, Zoltan H.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Introduction: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. Setting: Morristown Medical Center (MMC), Morristown, NJ Methods: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed. Results: 22% of admissions were HEMS and 78% were GEMS. HEMS patients had higher Injury Severity Scores (ISS) (p<0.001); however, mortality and length of stay were not statistically different. The percentage of pediatric patients transported by HEMS that were discharged home after emergency department evaluation was greater than the older populations (p<0.001). Older age and higher ISS had the largest impact on mortality (p<0.001). Conclusion: We believe our current use of HEMS is adequate since patient outcomes between HEMS and GEMS was similar, even though HEMS patients have higher ISS. However, helicopter use in the pediatric population was over-utilized, possibly due to the scarcity of hospitals capable of managing pediatric traumas. Implementation of the Air Medical Prehospital Triage scoring system may also help correct for these unnecessary HEMS transports.

AB - Introduction: Efficient patient transportation by ground emergency medical services (GEMS) or helicopter emergency medical services (HEMS) to a trauma center is vital for optimal care. We investigated differences between the modes of transport in terms of demographics, injury, scene location, and outcome. Setting: Morristown Medical Center (MMC), Morristown, NJ Methods: All 903 trauma admissions in 2016 by advanced life support (ALS) to MMC, a Level I Trauma Center, were retrospectively analyzed. Results: 22% of admissions were HEMS and 78% were GEMS. HEMS patients had higher Injury Severity Scores (ISS) (p<0.001); however, mortality and length of stay were not statistically different. The percentage of pediatric patients transported by HEMS that were discharged home after emergency department evaluation was greater than the older populations (p<0.001). Older age and higher ISS had the largest impact on mortality (p<0.001). Conclusion: We believe our current use of HEMS is adequate since patient outcomes between HEMS and GEMS was similar, even though HEMS patients have higher ISS. However, helicopter use in the pediatric population was over-utilized, possibly due to the scarcity of hospitals capable of managing pediatric traumas. Implementation of the Air Medical Prehospital Triage scoring system may also help correct for these unnecessary HEMS transports.

UR - http://www.scopus.com/inward/record.url?scp=85059943050&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85059943050&partnerID=8YFLogxK

U2 - 10.1016/j.amj.2018.11.013

DO - 10.1016/j.amj.2018.11.013

M3 - Article

C2 - 30898290

AN - SCOPUS:85059943050

VL - 38

SP - 95

EP - 99

JO - Air Medical Journal

JF - Air Medical Journal

SN - 1067-991X

IS - 2

ER -

Hakakian D, Kong K, Bogdanovski DA, Benvenuto A, DiFazio LT, Durling-Grover R et al. Analysis of Transport to an American College of Surgeons Level I Trauma Center. Air Medical Journal. 2019 Mar 1;38(2):95-99. https://doi.org/10.1016/j.amj.2018.11.013