Pediatric trauma patients are more likely to be discharged from the emergency department after arrival by helicopter emergency medical services

Abstract

Background: Despite faster transport times, concern about the safety of medical helicopters has led to scrutiny in the national media. Few criteria exist for the use of helicopter emergency medical services (HEMS). This study evaluated if pediatric trauma patients transported by HEMS from the injury scene were more likely to be discharged from the emergency department and more likely to be less severely injured based on Injury Severity Score (ISS) compared with adult patients.

Methods: Retrospective data were obtained from the trauma registry at our Level I trauma center between July 1, 2005, and June 30, 2009. Trauma patients arriving by HEMS from the injury scene were included. χ(2) was used to compare the discharge rate and the ISS (divided into 0-15 and 16-75) of the adult and pediatric populations. Pediatric patients were those younger than 16 years.

Results: A total of 2,897 trauma patients were transported by HEMS. A total of 247 (9%) were pediatric patients, and 2,650 (91%) were adults. Among the pediatric patients, 23% were discharged, and 77% were admitted. Of the adult patients, discharge occurred in 16%, and 84% were admitted. Comparison of the discharge rate between pediatric and adult patients revealed a significantly higher proportion of discharge among the pediatric patients (p < 0.01). Among the pediatric patients, 72% had an ISS of 0 to 15, and 28% had an ISS of 16 to 75. Among the adult patients, 55% had an ISS of 0 to 15, and 45% had an ISS of 16 to 75. Comparison of these groups revealed a statistically significantly lower ISS in the pediatric group (p < 0.01).

Conclusion: Consistent with a lower severity of injury, pediatric trauma patients transported by HEMS were more likely to be discharged directly from the emergency department when compared with adult patients.

Level of evidence: Epidemiologic study, level III.