Impact of emergency medical helicopter transport directly to a university hospital trauma center on mortality of severe blunt trauma patients until discharge

From Critical Care:

Introduction: The benefits of transporting severely injured patients by helicopter remains controversial. This study aimed to analyze the impact on mortality of helicopter compared to ground transport directly from the scene to a University hospital trauma center.

Methods: The French Intensive Care Research for Severe Trauma cohort study enrolled 2703 patients with severe blunt trauma requiring admission to University hospital intensive care units within 72 hours. Pre-hospital and hospital clinical data including the mode of transport, helicopter (HMICU) vs ground (GMICU), both with medical teams, were recorded. The analysis was restricted to patients admitted directly from the scene to a University hospital trauma center. The main endpoint was mortality until ICU discharge.

Results: Of the 1958 patients analyzed, 74% were transported by GMICU, 26% by HMICU. Median ISS was 26 (IQR 19-34) for HMICU patients and 25 (IQR 18-34) for GMICU patients. Compared to GMICU, HMICU patients had a higher median time frame before hospital admission and were more intensively treated in the pre-hospital phase. Crude mortality until hospital discharge was the same regardless of pre-hospital mode of transport. After adjustment for initial status, the risk of death was significantly lower (OR: 0.68, 95% CI 0.47-0.98, p=0.035) for HMICU compared with GMICU. This result did not change after further adjustment for ISS and overall surgical procedures.

Conclusion: This study suggests a beneficial impact of helicopter transport on mortality in severe blunt trauma. Whether this association could be due to better management in the pre-hospital phase needs to be more thoroughly assessed.

Drug Abuse Office Offers Videos for Docs

From MedPage Today:

The White House has launched another salvo in its war on prescription drug abuse and diversion: training videos for physicians.

The Office of National Drug Control Policy (ONDCP) on Monday released two online modules it developed to provide clinicians with training material and video vignettes modeling doctor-patient conversations on the safe use of opioid analgesics for pain.