Abstract
Background
A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome of their admission and length of hospital stay.
Methods
Details of all Helicopter Emergency Ambulance Service (HEAS) transfers to this unit in the study time period were obtained from the three HEAS providers in the area and case notes for all patients (where available) were reviewed.
Results
156 trauma patients were transferred (total patients 193). 111 cases were identified for analysis (45 transfers had inadequate information to identify them) with mean age of 33 years (range 1-92 years). Mean Injury Severity Score on admission was 12 (range 1-36). 45 (or 41%) patients were discharged home from the Accident and Emergency Department. 24 cases had operations, 9 patients required ICU care and 2 were pronounced dead on arrival in the A&E Department. Average hospital stay following HEAS transfer was 2.97 in-hospital days (range 0-18).
Conclusions
Pre-hospital Helicopter Ambulance transfer in the acute setting is of debatable value. There is no doubt that it can be an extremely valuable service but triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer (estimated costs per transfer range from £4,500 to £6,000). We present the data collected in this study. We propose that, if 41 percent of all trauma admissions transferred by helicopter ambulance are discharged home directly from the emergency department, the triage criteria for helicopter emergency ambulance transfer are at fault. We suggest that the triage criteria should be reviewed locally and nationally and the appropriate changes should then be implemented.
