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2010 Annual Meeting Abstracts

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Aeromedical Transport of Patients With Traumatic Injuries: Discharge Within 24 Hours
*Meredith J Sorensen, *Friedrich M von Recklinghausen, Rajan Gupta, Paul H Kispert
Dartmouth Hitchcock Medical Center, Lebanon, NH

Objective: Aeromedical transport moves some patients with minimal injuries from the scene and outside hospitals (OSH) to our trauma center. We sought to determine the frequency with which airlifted trauma patients required a hospital length of stay (LOS) of 24 hours or less, the condition of those patients, and the charges for their transport and hospital stay. Design: descriptive cross-sectional survey. Setting: Dartmouth Hitchcock Medical Center (DHMC) is a rural Level I trauma center served by two helicopters. Participants: 238 trauma patients airlifted to DHMC between 2005-2009 with <24 hour LOS discharged alive. Interventions: none
Main Outcome Measures: Origin of transport (scene or OSH), initial GCS (Glasgow Coma Score), and transport and hospital charges. Results: 1710 trauma patients were transferred by air from 2005-2009, and 238 (13.9%) had <24 hour LOS. Of those, 90.7% (216/238) came directly from the scene. They accounted for 26.6% (216/812) of all helicopter scene calls. 2.4% (22/898) of OSH transfers had <24 hour LOS. Average GCS for scene transfers upon helicopter arrival was 14.5 (95% CI 14.3, 14.8) and upon arrival to DHMC was 14.4 (95% CI 14.1, 14.7), p=0.49. Average GCS for interfacility transfers was 14.0 (95% CI 13.2, 14.7) at the OSH and 12.9 (95% CI 11.6, 14.1) upon arrival to DHMC (p=0.02). Average helicopter transport charges were $12,097 for scene calls and $13,938 for interfacility transfers, p=0.002. Average hospital charges were $14,035 for scene calls and $13,329 for interfacility transfers (p=0.47). Conclusions: Airlifted trauma patients frequently suffer minimal injuries and incur costs of transport that approximate hospital charges. Improved triage criteria should minimize cost and risk to the patient and air crews.

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