| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 10
| Issue : 1 | Page : 25-31 |
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Characteristics of scene trauma patients discharged within 24-hours of air medical transport
Christopher Gilliam1, David C Evans2, Chance Spalding3, Josh Burton3, Howard A Werman4
1 Ohio State University, College of Medicine, Mansfield, OH, USA
2 Department of Trauma Surgery, OhioHealth Mansfield Hospital, Mansfield, OH, USA
3 Department of Trauma Surgery, OhioHealth Grant Medical Center, Columbus, OH, USA
4 Department of Emergency Medicine, The Ohio State University, Columbus, OH, USA
Correspondence Address:
Dr. Howard A Werman
773 Prior Hall, 376 West 10th Avenue, Columbus, Ohio 43210
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/IJCIIS.IJCIIS_75_19
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Introduction: Helicopters play an important role in trauma; however, this service comes with safety risks, high transport costs, and downstream care charges.
Objective: Our objective was to determine the characteristics of early discharged trauma patients (<24 h length of stay) in order to reduce overtriage.
Methodology: Data were obtained from the trauma registries at one of two Level 1 trauma centers. Eligible patients included all scene trauma patients transported by helicopter to the Level 1 trauma centers from January 1, 2016, to December 31, 2017, who had a length of stay of 24 h or less. Patient factors such as age, gender, scene location, loaded miles, and transportation costs were collected. Trauma type, mechanism of injury, Abbreviated Injury Scale (AIS), Injury Severity Score, Revised Trauma Score, and prehospital vital signs were documented. Driving distances between the accident scene to local hospital, home of record to local hospital, and home of record to the Level I trauma center were also calculated for patients transported to Level 1 trauma center.
Results: Two hundred and twenty-six of 1042 total patients (21.7%) were discharged within 24 h of helicopter transport from the accident scene to trauma center. Less than 2% of patients were in the age group of 70 years or older. Only 2 (0.88%) patients discharged within 24 h had a prehospital systolic blood pressure <90 mmHg. For patients transported to Level 1 trauma center, the average loaded miles were 50.51 ± 14.99, with average transport charges being $27,921.19± $3536.61. Twenty-one percent of Level 1 trauma center patients were self-pay, and families typically drove 71.7 ± 123.23 miles to Level 1 trauma center versus 28.74 ± 40.62 to their local emergency department.
Conclusions: A significant number of patients transported from the scene are discharged within 24 h of admission to a trauma center. These patients rarely have prehospital hypotension, do not receive significant volumes of crystalloid resuscitation, and are infrequently over 70 years of age. One in five patients has no third-party coverage and assumes $27,921.19 in average transport charges.
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