Interfacility transfer of pediatric trauma patients by helicopter does not predict the need for urgent intervention

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8 Citations (Scopus)

Abstract

OBJECTIVES: Helicopter transport can allow trauma patients to reach definitive treatment rapidly, but its appropriate utilization for interfacility transfer to a pediatric trauma center (PTC) has not been well evaluated. This study evaluated differences in variables associated with transport type and intervention at a PTC between helicopter and ground transport for interfacility trauma transfers. METHODS: This retrospective study evaluated pediatric (<18 years old) trauma patients transferred to a rural PTC over a 5-year period. Records (n = 423) were evaluated for transport type, injuries, mechanism, interventions (eg, operations, transfusions, intubation), and treatment time points. Multiple logistic regression and Cox regression survival analyses were performed to evaluate associations with type of transport and interventions. RESULTS: Thirty-five percent of patients received intervention at the PTC, with no significant difference between transport types. Helicopter transport was associated with transport distance, respiratory rate greater than 30 breaths/min, pedestrian struck by auto, subdural hematoma, epidural hematoma, pneumothorax, solid organ injury, and vascular compromise/open fracture. Intervention was associated with epidural hematoma, extremity and pelvic fractures, vascular compromise/open fracture, penetrating neck/trunk injury, and complex laceration. Cox regression at less than 6, less than 4, and less than 2 hours after arrival at the PTC demonstrated similar intervention associations. Helicopter transport also correlated with intervention at these time points. CONCLUSIONS: Most pediatric trauma patients transferred by helicopter did not require interventions. Epidural hematoma, vascular compromise/open fracture, and penetrating neck/trunk injuries predicted prompt interventions (<2 hours) and may have benefited from helicopter transport. There was a disparity between the perceived need for rapid transport and the need for urgent interventions.

Original languageEnglish (US)
Pages (from-to)729-736
Number of pages8
JournalPediatric Emergency Care
Volume29
Issue number6
DOIs
StatePublished - Jun 1 2013

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Aircraft
Trauma Centers
Pediatrics
Wounds and Injuries
Open Fractures
Hematoma
Neck Injuries
Blood Vessels
Subdural Hematoma
Lacerations
Vascular System Injuries
Pneumothorax
Survival Analysis
Respiratory Rate
Intubation
Extremities
Retrospective Studies
Logistic Models
Regression Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

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title = "Interfacility transfer of pediatric trauma patients by helicopter does not predict the need for urgent intervention",
abstract = "OBJECTIVES: Helicopter transport can allow trauma patients to reach definitive treatment rapidly, but its appropriate utilization for interfacility transfer to a pediatric trauma center (PTC) has not been well evaluated. This study evaluated differences in variables associated with transport type and intervention at a PTC between helicopter and ground transport for interfacility trauma transfers. METHODS: This retrospective study evaluated pediatric (<18 years old) trauma patients transferred to a rural PTC over a 5-year period. Records (n = 423) were evaluated for transport type, injuries, mechanism, interventions (eg, operations, transfusions, intubation), and treatment time points. Multiple logistic regression and Cox regression survival analyses were performed to evaluate associations with type of transport and interventions. RESULTS: Thirty-five percent of patients received intervention at the PTC, with no significant difference between transport types. Helicopter transport was associated with transport distance, respiratory rate greater than 30 breaths/min, pedestrian struck by auto, subdural hematoma, epidural hematoma, pneumothorax, solid organ injury, and vascular compromise/open fracture. Intervention was associated with epidural hematoma, extremity and pelvic fractures, vascular compromise/open fracture, penetrating neck/trunk injury, and complex laceration. Cox regression at less than 6, less than 4, and less than 2 hours after arrival at the PTC demonstrated similar intervention associations. Helicopter transport also correlated with intervention at these time points. CONCLUSIONS: Most pediatric trauma patients transferred by helicopter did not require interventions. Epidural hematoma, vascular compromise/open fracture, and penetrating neck/trunk injuries predicted prompt interventions (<2 hours) and may have benefited from helicopter transport. There was a disparity between the perceived need for rapid transport and the need for urgent interventions.",
author = "Engbrecht, {Brett W.} and Hollenbeak, {Christopher S.} and Lubin, {Jeffrey S.} and Cilley, {Robert E.}",
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T1 - Interfacility transfer of pediatric trauma patients by helicopter does not predict the need for urgent intervention

AU - Engbrecht, Brett W.

AU - Hollenbeak, Christopher S.

AU - Lubin, Jeffrey S.

AU - Cilley, Robert E.

PY - 2013/6/1

Y1 - 2013/6/1

N2 - OBJECTIVES: Helicopter transport can allow trauma patients to reach definitive treatment rapidly, but its appropriate utilization for interfacility transfer to a pediatric trauma center (PTC) has not been well evaluated. This study evaluated differences in variables associated with transport type and intervention at a PTC between helicopter and ground transport for interfacility trauma transfers. METHODS: This retrospective study evaluated pediatric (<18 years old) trauma patients transferred to a rural PTC over a 5-year period. Records (n = 423) were evaluated for transport type, injuries, mechanism, interventions (eg, operations, transfusions, intubation), and treatment time points. Multiple logistic regression and Cox regression survival analyses were performed to evaluate associations with type of transport and interventions. RESULTS: Thirty-five percent of patients received intervention at the PTC, with no significant difference between transport types. Helicopter transport was associated with transport distance, respiratory rate greater than 30 breaths/min, pedestrian struck by auto, subdural hematoma, epidural hematoma, pneumothorax, solid organ injury, and vascular compromise/open fracture. Intervention was associated with epidural hematoma, extremity and pelvic fractures, vascular compromise/open fracture, penetrating neck/trunk injury, and complex laceration. Cox regression at less than 6, less than 4, and less than 2 hours after arrival at the PTC demonstrated similar intervention associations. Helicopter transport also correlated with intervention at these time points. CONCLUSIONS: Most pediatric trauma patients transferred by helicopter did not require interventions. Epidural hematoma, vascular compromise/open fracture, and penetrating neck/trunk injuries predicted prompt interventions (<2 hours) and may have benefited from helicopter transport. There was a disparity between the perceived need for rapid transport and the need for urgent interventions.

AB - OBJECTIVES: Helicopter transport can allow trauma patients to reach definitive treatment rapidly, but its appropriate utilization for interfacility transfer to a pediatric trauma center (PTC) has not been well evaluated. This study evaluated differences in variables associated with transport type and intervention at a PTC between helicopter and ground transport for interfacility trauma transfers. METHODS: This retrospective study evaluated pediatric (<18 years old) trauma patients transferred to a rural PTC over a 5-year period. Records (n = 423) were evaluated for transport type, injuries, mechanism, interventions (eg, operations, transfusions, intubation), and treatment time points. Multiple logistic regression and Cox regression survival analyses were performed to evaluate associations with type of transport and interventions. RESULTS: Thirty-five percent of patients received intervention at the PTC, with no significant difference between transport types. Helicopter transport was associated with transport distance, respiratory rate greater than 30 breaths/min, pedestrian struck by auto, subdural hematoma, epidural hematoma, pneumothorax, solid organ injury, and vascular compromise/open fracture. Intervention was associated with epidural hematoma, extremity and pelvic fractures, vascular compromise/open fracture, penetrating neck/trunk injury, and complex laceration. Cox regression at less than 6, less than 4, and less than 2 hours after arrival at the PTC demonstrated similar intervention associations. Helicopter transport also correlated with intervention at these time points. CONCLUSIONS: Most pediatric trauma patients transferred by helicopter did not require interventions. Epidural hematoma, vascular compromise/open fracture, and penetrating neck/trunk injuries predicted prompt interventions (<2 hours) and may have benefited from helicopter transport. There was a disparity between the perceived need for rapid transport and the need for urgent interventions.

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