Scene Transport of Pediatric Patients Injured at Winter Resorts

Objective. To examine the characteristics of pediatric patients (age ≤16 years) injured at winter resort scenes andtransported by helicopter emergency medical services (HEMS) or ground EMS (GEMS) ambulance services to regional trauma centers. Methods. Between 1997 and2001, a total of 119 patients (GEMS = 69; HEMS = 50) were identified from trauma registries andHEMS transport records. Demographic data, initial vital signs, hospital interventions, anddischarge status of the two groups were examined. Results. The distributions of gender, initial vital signs, Injury Severity Score (ISS; either ≤ or > 15), intensive care unit (ICU) length of stay (LOS), total hospital LOS, andhome discharge status were similar between the two groups (p ≥ 0.05). Patients transported by HEMS were older (14 ± 2 vs. 10 ± 4, p < 0.001), less likely to be admitted to the hospital (73% vs. 98.5%; p < 0.001), andmore likely to have multiple injuries [13 (27%) vs. 8 (11.6%), p ≤ 0.032]. The GEMS patients had a higher rate of isolated extremity [33 (80.5%) vs. 8 (19.5%)] andthoracoabdominal [11 (73.3%) vs. 4 (26.7%)] injuries. The high orthopedic injury rate in the GEMS patients contributed to a higher rate of surgery in this group (45% vs. 24%, p ≤ 0.028). Regardless of transport mode, patients requiring immediate interventions (intubation, chest tube placement, or blood product administration) had either a depressed level of consciousness (GCS = 12) on emergency department arrival or thoracoabdominal injuries. No deaths were recorded. Conclusions. Patients transported by HEMS andGEMS had similar hospital characteristics but different injury patterns. A prospective study examining the initial triage of pediatric patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.