Impact of discontinuing a hospital-based air ambulance service on trauma patient outcomes
ABSTRACT The clinical benefit of aeromedical transportation of injured patients in the civilian population has been debated. The purpose of this study was to examine the effects of discontinuing a hospital-based helicopter transport program on trauma patient outcomes, with the hypothesis that the loss of an air ambulance would result in increased transport time and increased mortality among severely injured patients.
Data on injury severity and patient outcomes were collected prospectively for the 12 months immediately preceding and 24 months following discontinuation of the helicopter ambulance service. Transport time, mortality rate, and hospital length of stay was compared.
The number of trauma patient admissions decreased 12%, with a 17% decrease in admissions of severely injured patients. Transport time decreased, with no change in mortality.
Discontinuation of a hospital-based air ambulance service did not increase transport time or increase mortality for trauma patients.
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Article: NATIONAL TRANSPORTATION SAFETY BOARD
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ABSTRACT: This study represents a comparison of Helicopter Emergency Medical Services (HEMS) operations, between US Federal Aviation Regulations (FARs), and European Joint Aviation Regulations Operations Specifications. Presently, US regulations allow HEMS operators to conduct work under FAR Part 135, Commercial Aviation Operations, or under FAR Part 91, General Aviation Operations. This allows HEMS operators to accept a greater level of risk by substituting lower minimum procedural standards under FAR Part 91 than under FAR Part 135, and may be partly culpable for a higher rate of fatal crashes in HEMS operations conducted under FAR Part 91. In stark contrast, explicit criteria and minimum operating considerations are stated in the European regulations. The Federal Aviation Administration (FAA) has been slow to take a similar clear and firm regulatory stance as that of its European counterpart regarding the human factors involved in the risk assessment of HEMS operations. Providing clearly defined steps to analyze and mitigate unnecessary threats, developing optimum performance guidelines, as well as minimum acceptable operational standards would benefit not only the US HEMS industry but also the patients and public it serves by reducing exposure to preventable dangers.