Helicopter and Ground Emergency Medical Services Transportation to Hospital after Major Trauma in England, a Comparative Cohort Study

Description

In this presentation, Oliver Beaumont, an ST5 in Severn, discusses the effectiveness of Helicopter Emergency Medical Services (HEMS) compared to traditional ground ambulance services for patients with major trauma. Starting with the background context, Beaumont explains how the care of trauma patients initiates at the time of injury, underpinning the relevance of rapid transportation in emergency scenarios. He acknowledges the publication of a prior paper related to this subject and expresses appreciation for his co-authors' contributions.



Highlighting the advantages of HEMS, which include the ability to cover long distances quickly and provide specialized medical teams on-site, he outlines both the strengths and limitations of such services. Notably, he points out that while HEMS can access remote locations, their use can sometimes delay transportation to hospitals due to prolonged on-scene interventions.



To assess the impact of HEMS on patient outcomes, Beaumont analyzes data from the Trauma Audit and Research Network (TARN), focusing on a cohort of around 300,000 patients linked to a Major Trauma Network initiated in 2012. This large dataset allows for the comparison between nearly 7,500 HEMS patients and a matched group of ground ambulance responders, the aim being to evaluate differences in 30-day mortality rates.



Through logistic regression analysis, he reveals that while the HEMS response led to a 15% reduction in mortality among patients, this result did not reach statistical significance due to wide confidence intervals. A more refined analysis involving only patients who were treated by ground ambulance but had a physician on scene showed a statistically significant 23% reduction in mortality.



Concluding the talk, Beaumont emphasizes the difficulty of deriving definitive conclusions given the non-randomized nature of HEMS studies, but identifies the necessity of improving data collection and reporting practices across varying services to better address the cost-effectiveness of HEMS, which can cost up to £30,000 per response.

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