Optimizing Transport Time from Accident to Hospital: When to Drive and When to Fly?

Abstract

Objective. In prehospital emergency medicine, rapid transport to a hospital is often required. Transport can be done by ambulance or HEMS (Helicopter Emergency Medical Service). Factors influencing transport time are mostly unknown. This study aims to identify these factors and optimize prehospital transport times. Methods. This is a retrospective study with HEMS data from 2010-2011. Trauma mechanism, patient characteristics, and weather conditions were collected from each transport. Distance to the hospital, predicted transport time, and the actual transport time were calculated. Each factor was analysed to determine influence on transport time. Results. We analysed 732 cases (612 by ambulance and 120 by helicopter) and found no association between mechanism of trauma, age, time of day, or weather conditions on transport time. However, transport by HEMS helicopter was nearly always faster, even at short distances. The average transport time of ambulance transport was 79% (95% CI 77.1–80.3) of target time, while in helicopter transport this was 39% (95% CI 37.4–42.9). Conclusion. This study shows the advantage of the HEMS helicopter in rapid transport from the scene to the hospital. Transport by helicopter was twice as fast as ground transport, independent of trauma mechanism, distance to hospital, or weather conditions.