Skip to main content
Emergency Medicine Journal : EMJ logoLink to Emergency Medicine Journal : EMJ
. 2004 May;21(3):355–361. doi: 10.1136/emj.2002.004473

Appropriate use of helicopters to transport trauma patients from incident scene to hospital in the United Kingdom: an algorithm

J Black 1, M Ward 1, D Lockey 1
PMCID: PMC1726327  PMID: 15107383

Full Text

The Full Text of this article is available as a PDF (541.0 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abbott D., Brauer K., Hutton K., Rosen P. Aggressive out-of-hospital treatment regimen for severe closed head injury in patients undergoing air medical transport. Air Med J. 1998 Jul-Sep;17(3):94–100. doi: 10.1016/s1067-991x(98)90102-x. [DOI] [PubMed] [Google Scholar]
  2. Acosta J. A., Yang J. C., Winchell R. J., Simons R. K., Fortlage D. A., Hollingsworth-Fridlund P., Hoyt D. B. Lethal injuries and time to death in a level I trauma center. J Am Coll Surg. 1998 May;186(5):528–533. doi: 10.1016/s1072-7515(98)00082-9. [DOI] [PubMed] [Google Scholar]
  3. Albert John, Phillips Hugh. Trauma care systems in the United Kingdom. Injury. 2003 Sep;34(9):728–734. doi: 10.1016/s0020-1383(03)00151-7. [DOI] [PubMed] [Google Scholar]
  4. Anderson I. D., Woodford M., de Dombal F. T., Irving M. Retrospective study of 1000 deaths from injury in England and Wales. Br Med J (Clin Res Ed) 1988 May 7;296(6632):1305–1308. doi: 10.1136/bmj.296.6632.1305. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Anderson T. E., Rose W. D., Leicht M. J. Physician-staffed helicopter scene response from a rural trauma center. Ann Emerg Med. 1987 Jan;16(1):58–61. doi: 10.1016/s0196-0644(87)80288-3. [DOI] [PubMed] [Google Scholar]
  6. Bartolacci R. A., Munford B. J., Lee A., McDougall P. A. Air medical scene response to blunt trauma: effect on early survival. Med J Aust. 1998 Dec 7;169(11-12):612–616. doi: 10.5694/j.1326-5377.1998.tb123435.x. [DOI] [PubMed] [Google Scholar]
  7. Baxt W. G., Moody P., Cleveland H. C., Fischer R. P., Kyes F. N., Leicht M. J., Rouch F., Wiest P. Hospital-based rotorcraft aeromedical emergency care services and trauma mortality: a multicenter study. Ann Emerg Med. 1985 Sep;14(9):859–864. doi: 10.1016/s0196-0644(85)80634-x. [DOI] [PubMed] [Google Scholar]
  8. Baxt W. G., Moody P. The impact of a physician as part of the aeromedical prehospital team in patients with blunt trauma. JAMA. 1987 Jun 19;257(23):3246–3250. [PubMed] [Google Scholar]
  9. Baxt W. G., Moody P. The impact of advanced prehospital emergency care on the mortality of severely brain-injured patients. J Trauma. 1987 Apr;27(4):365–369. doi: 10.1097/00005373-198704000-00004. [DOI] [PubMed] [Google Scholar]
  10. Braude Darren, Domeier Robert M. Prehospital care for road traffic casualties. Spinal immobilisation should be done selectively. BMJ. 2002 Aug 3;325(7358):279–279. [PubMed] [Google Scholar]
  11. Burney R. E., Hubert D., Passini L., Maio R. Variation in air medical outcomes by crew composition: a two-year follow-up. Ann Emerg Med. 1995 Feb;25(2):187–192. doi: 10.1016/s0196-0644(95)70322-5. [DOI] [PubMed] [Google Scholar]
  12. Butler F. K., Jr, Hagmann J., Butler E. G. Tactical combat casualty care in special operations. Mil Med. 1996 Aug;161 (Suppl):3–16. doi: 10.1007/978-3-319-56780-8_1. [DOI] [PubMed] [Google Scholar]
  13. Cales R. H., Trunkey D. D. Preventable trauma deaths. A review of trauma care systems development. JAMA. 1985 Aug 23;254(8):1059–1063. doi: 10.1001/jama.254.8.1059. [DOI] [PubMed] [Google Scholar]
  14. Cameron P. A., Flett K., Kaan E., Atkin C., Dziukas L. Helicopter retrieval of primary trauma patients by a paramedic helicopter service. Aust N Z J Surg. 1993 Oct;63(10):790–797. doi: 10.1111/j.1445-2197.1993.tb00342.x. [DOI] [PubMed] [Google Scholar]
  15. Cameron P. A. Helicopter transport: can physicians save lives? Aust N Z J Surg. 1999 Oct;69(10):690–691. doi: 10.1046/j.1440-1622.1999.01687.x. [DOI] [PubMed] [Google Scholar]
  16. Cameron P. A., Zalstein S. Transport of the critically ill. Med J Aust. 1998 Dec 7;169(11-12):610–611. doi: 10.5694/j.1326-5377.1998.tb123434.x. [DOI] [PubMed] [Google Scholar]
  17. Champion H. R., Sacco W. J., Carnazzo A. J., Copes W., Fouty W. J. Trauma score. Crit Care Med. 1981 Sep;9(9):672–676. doi: 10.1097/00003246-198109000-00015. [DOI] [PubMed] [Google Scholar]
  18. Champion H. R., Sacco W. J., Copes W. S., Gann D. S., Gennarelli T. A., Flanagan M. E. A revision of the Trauma Score. J Trauma. 1989 May;29(5):623–629. doi: 10.1097/00005373-198905000-00017. [DOI] [PubMed] [Google Scholar]
  19. Chesnut R. M., Marshall L. F., Klauber M. R., Blunt B. A., Baldwin N., Eisenberg H. M., Jane J. A., Marmarou A., Foulkes M. A. The role of secondary brain injury in determining outcome from severe head injury. J Trauma. 1993 Feb;34(2):216–222. doi: 10.1097/00005373-199302000-00006. [DOI] [PubMed] [Google Scholar]
  20. Coats T. J., Davies G. Prehospital care for road traffic casualties. BMJ. 2002 May 11;324(7346):1135–1138. doi: 10.1136/bmj.324.7346.1135. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Coats T. J., Keogh S., Clark H., Neal M. Prehospital resuscitative thoracotomy for cardiac arrest after penetrating trauma: rationale and case series. J Trauma. 2001 Apr;50(4):670–673. doi: 10.1097/00005373-200104000-00012. [DOI] [PubMed] [Google Scholar]
  22. Coats T. J., Kirk C. J., Dawson M. Outcome after severe head injury treated by an integrated trauma system. J Accid Emerg Med. 1999 May;16(3):182–185. doi: 10.1136/emj.16.3.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Cocanour C. S., Fischer R. P., Ursic C. M. Are scene flights for penetrating trauma justified? J Trauma. 1997 Jul;43(1):83–88. doi: 10.1097/00005373-199707000-00019. [DOI] [PubMed] [Google Scholar]
  24. Dalton A. M., Botha A., Coats T., Spalding T., Hodkinson S., Warren C., Hodgson R. Helicopter doctors? Injury. 1992;23(4):249–250. doi: 10.1016/s0020-1383(05)80009-9. [DOI] [PubMed] [Google Scholar]
  25. Falcone R. E., Herron H., Johnson R., Childress S., Lacey P., Scheiderer G. Air medical transport for the trauma patient requiring cardiopulmonary resuscitation: a 10-year experience. Air Med J. 1995 Oct-Dec;14(4):197–205. doi: 10.1016/1067-991x(95)90002-0. [DOI] [PubMed] [Google Scholar]
  26. Fischer R. P., Flynn T. C., Miller P. W., Duke J. H., Jr Urban helicopter response to the scene of injury. J Trauma. 1984 Nov;24(11):946–951. doi: 10.1097/00005373-198411000-00004. [DOI] [PubMed] [Google Scholar]
  27. Garner A., Rashford S., Lee A., Bartolacci R. Addition of physicians to paramedic helicopter services decreases blunt trauma mortality. Aust N Z J Surg. 1999 Oct;69(10):697–701. doi: 10.1046/j.1440-1622.1999.01688.x. [DOI] [PubMed] [Google Scholar]
  28. Goldstein Leanelle, Doig Christopher J., Bates Sarah, Rink Sandra, Kortbeek John B. Adopting the pre-hospital index for interfacility helicopter transport: a proposal. Injury. 2003 Jan;34(1):3–11. doi: 10.1016/s0020-1383(02)00082-7. [DOI] [PubMed] [Google Scholar]
  29. Gorman D. F., Teanby D. N., Sinha M. P., Wotherspoon J., Boot D. A., Molokhia A. The epidemiology of major injuries in Mersey Region and North Wales. Injury. 1995 Jan;26(1):51–54. doi: 10.1016/0020-1383(95)90553-a. [DOI] [PubMed] [Google Scholar]
  30. Hamman B. L., Cué J. I., Miller F. B., O'Brien D. A., House T., Polk H. C., Jr, Richardson J. D. Helicopter transport of trauma victims: does a physician make a difference? J Trauma. 1991 Apr;31(4):490–494. doi: 10.1097/00005373-199104000-00007. [DOI] [PubMed] [Google Scholar]
  31. Henderson K. I., Coats T. J., Hassan T. B., Brohi K. Audit of time to emergency trauma laparotomy. Br J Surg. 2000 Apr;87(4):472–476. doi: 10.1046/j.1365-2168.2000.01392.x. [DOI] [PubMed] [Google Scholar]
  32. Holcomb John B. Fluid resuscitation in modern combat casualty care: lessons learned from Somalia. J Trauma. 2003 May;54(5 Suppl):S46–S51. doi: 10.1097/01.TA.0000051936.91915.A2. [DOI] [PubMed] [Google Scholar]
  33. Hoyt D. B., Bulger E. M., Knudson M. M., Morris J., Ierardi R., Sugerman H. J., Shackford S. R., Landercasper J., Winchell R. J., Jurkovich G. Death in the operating room: an analysis of a multi-center experience. J Trauma. 1994 Sep;37(3):426–432. [PubMed] [Google Scholar]
  34. Hoyt David B. Fluid resuscitation: the target from an analysis of trauma systems and patient survival. J Trauma. 2003 May;54(5 Suppl):S31–S35. doi: 10.1097/01.TA.0000047221.49816.0C. [DOI] [PubMed] [Google Scholar]
  35. Lerner E. B., Billittier A. S. Delay in ED arrival resulting from a remote helipad at a trauma center. Air Med J. 2000 Oct-Dec;19(4):134–136. doi: 10.1016/s1067-991x(00)90003-8. [DOI] [PubMed] [Google Scholar]
  36. Lockey D. J. Prehospital trauma management. Resuscitation. 2001 Jan;48(1):5–15. doi: 10.1016/s0300-9572(00)00313-0. [DOI] [PubMed] [Google Scholar]
  37. Lockey D., Davies G., Coats T. Survival of trauma patients who have prehospital tracheal intubation without anaesthesia or muscle relaxants: observational study. BMJ. 2001 Jul 21;323(7305):141–141. doi: 10.1136/bmj.323.7305.141. [DOI] [PMC free article] [PubMed] [Google Scholar]
  38. Lossius H. M., Søreide E., Hotvedt R., Hapnes S. A., Eielsen O. V., Førde O. H., Steen P. A. Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained? Acta Anaesthesiol Scand. 2002 Aug;46(7):771–778. doi: 10.1034/j.1399-6576.2002.460703.x. [DOI] [PubMed] [Google Scholar]
  39. Malacrida R. L., Anselmi L. C., Genoni M., Bogen M., Suter P. M. Helicopter mountain rescue of patients with head injury and/or multiple injuries in southern Switzerland 1980-1990. Injury. 1993 Aug;24(7):451–453. doi: 10.1016/0020-1383(93)90147-x. [DOI] [PubMed] [Google Scholar]
  40. Maslanka A. M. Scoring systems and triage from the field. Emerg Med Clin North Am. 1993 Feb;11(1):15–27. [PubMed] [Google Scholar]
  41. Moeschler O., Refondini S., Höfliger C., Freeman J. Difficult aeromedical rescue situations: experience of a Swiss pre-alpine helicopter base. J Trauma. 1992 Nov;33(5):754–759. [PubMed] [Google Scholar]
  42. Nardi G., Massarutti D., Muzzi R., Kette F., De Monte A., Carnelos G. A., Peressutti R., Berlot G., Giordano F., Gullo A. Impact of emergency medical helicopter service on mortality for trauma in north-east Italy. A regional prospective audit. Eur J Emerg Med. 1994 Jun;1(2):69–77. [PubMed] [Google Scholar]
  43. Nicholl J. P., Brazier J. E., Snooks H. A. Effects of London helicopter emergency medical service on survival after trauma. BMJ. 1995 Jul 22;311(6999):217–222. doi: 10.1136/bmj.311.6999.217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Phillips R. T., Conaway C., Mullarkey D., Owen J. L. One year's trauma mortality experience at Brooke Army Medical Center: is aeromedical transportation of trauma patients necessary? Mil Med. 1999 May;164(5):361–365. [PubMed] [Google Scholar]
  45. Rhee K. J., Strozeski M., Burney R. E., Mackenzie J. R., LaGreca-Reibling K. Is the flight physician needed for helicopter emergency medical services? Ann Emerg Med. 1986 Feb;15(2):174–177. doi: 10.1016/s0196-0644(86)80015-4. [DOI] [PubMed] [Google Scholar]
  46. Rhodes M., Perline R., Aronson J., Rappe A. Field triage for on-scene helicopter transport. J Trauma. 1986 Nov;26(11):963–969. doi: 10.1097/00005373-198611000-00002. [DOI] [PubMed] [Google Scholar]
  47. Salkin B. Prehospital care for road traffic casualties. Doctors should offer themselves as a resource. BMJ. 2002 Aug 3;325(7358):279–279. [PubMed] [Google Scholar]
  48. Schwartz R. J., Jacobs L. M., Juda R. J. A comparison of ground paramedics and aeromedical treatment of severe blunt trauma patients. Conn Med. 1990 Dec;54(12):660–662. [PubMed] [Google Scholar]
  49. Sevitt S. Fatal road accidents. Injuries, complications, and causes of death in 250 subjects. Br J Surg. 1968 Jul;55(7):481–505. doi: 10.1002/bjs.1800550702. [DOI] [PubMed] [Google Scholar]
  50. Smith H. P. Time to die from injuries received in road traffic accidents. Injury. 1970 Oct;2(2):99–102. doi: 10.1016/s0020-1383(70)80007-9. [DOI] [PubMed] [Google Scholar]
  51. Templeton J. Watson Jones Lecture. The organisation of trauma services in the UK. Ann R Coll Surg Engl. 2000 Jan;82(1):49–52. [PMC free article] [PubMed] [Google Scholar]
  52. Trunkey D. D. Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research. Sci Am. 1983 Aug;249(2):28–35. [PubMed] [Google Scholar]
  53. Wall M. J., Jr, Pepe P. E., Mattox K. L. Successful roadside resuscitative thoracotomy: case report and literature review. J Trauma. 1994 Jan;36(1):131–134. [PubMed] [Google Scholar]
  54. Wills V. L., Eno L., Walker C., Gani J. S. Use of an ambulance-based helicopter retrieval service. Aust N Z J Surg. 2000 Jul;70(7):506–510. doi: 10.1046/j.1440-1622.2000.01893.x. [DOI] [PubMed] [Google Scholar]
  55. Wirtz Mary H., Cayten C. Gene, Kohrs Deborah A., Atwater Rob, Larsen Erik A. Paramedic versus nurse crews in the helicopter transport of trauma patients. Air Med J. 2002 Jan-Feb;21(1):17–21. doi: 10.1067/mmj.2002.121714. [DOI] [PubMed] [Google Scholar]
  56. Wright K. D., Knowles C. H., Coats T. J., Sutcliffe J. C. 'Efficient' timely evacuation of intracranial haematoma--the effect of transport direct to a specialist centre. Injury. 1996 Dec;27(10):719–721. doi: 10.1016/s0020-1383(96)00119-2. [DOI] [PubMed] [Google Scholar]
  57. Young J. S., Bassam D., Cephas G. A., Brady W. J., Butler K., Pomphrey M. Interhospital versus direct scene transfer of major trauma patients in a rural trauma system. Am Surg. 1998 Jan;64(1):88–92. [PubMed] [Google Scholar]

Associated Data

This section collects any data citations, data availability statements, or supplementary materials included in this article.

Supplementary Materials

[Figure 1 in Colour]
emermedj_21_3_355__1.pdf (31.2KB, pdf)

Articles from Emergency Medicine Journal : EMJ are provided here courtesy of BMJ Publishing Group

RESOURCES