Treatment Experiences of Traumatic Brain Injury Patients using Doctor-Helicopter Emergency Medical Service: Early Data in a Regional Trauma Center

Objective

The purpose of this study is to analyze the results of doctor helicopter emergency medical service (HEMS) in traumatic brain injury (TBI) patients and to understand the effect and improvement of doctor HEMS.

Methods

We included TBI patients transferred by doctor HEMS of our hospital between February 2016 and December 2017. Basic characteristics, HEMS data, treatment and results data were analyzed retrospectively. We divided the patients into 3 groups as regarding severity of patient, relevance of treatment and transfer. We investigated the preventable trauma death rate (PTDR) of these groups to increase the reliability of the treatment outcome.

Results

TBI patients using doctor HEMS were indicated in 98 patients (18.7%) among 522 overall HEMS patients. The overall mortality was consisted in 21.4% and 43.2% was resulted in Glasgow outcome scale 4 or 5. The group of proper transport and treatment for severe TBI was consisted in 62.2% including 13 mortality cases and no preventable death. The group of delayed transport or treatment for severe TBI was 18.3% including 8 mortality cases and 1 preventable death. The PTDR of TBI after doctor HEMS was significantly lower than that of overall TBI (4.8% vs. 11.6%, p=0.045).

Conclusion

In patients with severe TBI, doctor HEMS can improve treatment outcomes by reducing treatment delay and unnecessary examinations and this result was evidenced that the PTDR were decreased significantly after doctor HEMS transport. The appropriate treatment is mandatory for real-time communication with the emergency doctor and treatment preparation of the trauma team during the HEMS transport.