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Abstract

Background: Helicopter emergency medical services have become an integral part of trauma systems. When appropriately utilized, helicopter transport can improve the outcomes of trauma patients. The objective of this study was to determine if helicopter transport for interfacility transfers was effective in reducing time-to-treatment for isolated open fractures in the setting of a rural Level I trauma center. The authors hypothesized that helicopter transportation of isolated open fractures would not reduce time to definitive fixation.

Methods: All patients treated with isolated open fractures over a four-year period at a Level I trauma center were identified. In this study, the authors included 76 medically stable patients with an isolated open fracture that were transferred from an outside facility. The records were reviewed recording the time of acceptance by the Level I trauma center, arrival time at the trauma center, and the start of operative treatment of the open fracture.

Results: The speed of transfer was faster (helicopter 43.4 miles/hour, ground 33.4 miles/hour, P <0.0001), and transfer time shorter (helicopter mean 151 minutes, ground 181 minutes, P = 0.0255) for patients transfered by helicopter. However, the time-to-treatment in an operating theater (helicopter 412 minutes, ground 445 minutes, P = 0.511) was not significantly different.

Conclusion: For isolated open fractures in a rural trauma system, there is no time-to-treatment advantage of helicopter over ground transportation. The perceived speed of helicopter transfers should not be used as a justification to select helicopter over ground transport for patients with isolated open fractures.

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