U.K. emergency helicopter ambulance services may be over-used for minor injuries

British researchers find that helicopter emergency transfers to their hospital have an Injury Severity Score below 12.

GLASGOW, Scotland — Hospitals in the United Kingdom may be transferring too many patients with minor injuries using helicopter emergency ambulance services, according to a surgeon speaking here.

Joel Melton, FRCS, and colleagues at Great Western Hospital in Swindon, England, examined case mix and severity of injuries among patients admitted to hospitals via helicopter transport between January 2003 and September 2004. Melton presented the study results at the British Orthopaedic Association Annual Congress.

The researchers identified 156 trauma patients, but excluded 45 patients from the study because of inadequate or incorrect patient details. The 111 remaining patients averaged 33 years of age, and 73 patients were men. Most patients — 59 — were injured in motor vehicle crashes, and 24 patients were injured in horse-riding accidents, Melton said.

The researchers found patients had a mean Injury Severity Score of 12 (range, 1 to 36), which was "surprising" for this population, Melton said.

"We found that the majority [of patients] were the minor-injured. We were very much expecting a skew of this data ... towards the major-injured patients," he said, noting that hospitals directly discharged 48 of the 111 patients from the emergency department.

Of those not directly discharged, surgeons operated on 24 patients, 10 patients were treated in the intensive care unit and two patients were pronounced dead on arrival. Long-term outcomes were not available for most patients, but researchers did find eight complications, Melton said.

"There is good evidence now to suggest that if your Injury Severity Score is less than 12, helicopter transfer rarely results in an improvement in outcome," Melton said. "It's difficult to justify helicopter transfer for patients with minor injuries."

Melton and his colleagues suggested that researchers further evaluate helicopter emergency ambulance service criteria, review the benefits of helicopter service and review triage criteria on a regional and national level.

For more information:
Melton J, Jain S, Kendrick B, et al. Pre-hospital patient transfer by helicopter ambulance: Should triage criteria be changed? Presented at the British Orthopaedic Association Annual Congress. Sept. 27-29, 2006. Glasgow, Scotland.