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Helicopter Medevacs Save Trauma Patient Lives But Are Costly

Medevac helicopter (


A study led by researchers at Johns Hopkins University in Baltimore shows helicopter transport increases the survival rate of trauma victims brought to hospitals compared to ground transport, but the costs are high and better guidelines are needed to determine when to use this resource. The findings are published in this week’s issue of the Journal of the American Medical Association (paid subscription required).

The study team led by Adil Haider, a professor in the Johns Hopkins University medical school, examined records from more than 223,000 patients, age 16 and older, from the 2007-2009 National Trauma Data Bank. All patients sustained at least moderately severe injuries and were taken to trauma centers. The researchers compared the more than 161,500 patients who were transported by ambulance to the nearly 62,000 who were transported by helicopter.

The team, including researchers from University of Maryland, Thomas Jefferson University in Philadelphia, and Aga Khan University in Pakistan, as well as colleagues from Johns Hopkins, compared the survival rates of patients transported by helicopter versus those driven by ambulance. In making the comparisons, they controlled for such factors as injury severity, type of injury, and age of the patient.

The researchers calculated that patients transported to the hospital by air were 16 percent more likely to survive than similarly injured patients transported by ground. The team also estimated that one in 65 significantly injured patients brought to a level 1 trauma center — those delivering comprehensive trauma care — by helicopter would die if ground transportation was the only option.

The Centers for Disease Control and Prevention says that injuries are the leading cause of death for people under the age of 45 in the U.S., with more than 180,000 people dying from injuries each year, at a cost more than $406 billion annually in medical care and lost productivity. But trauma centers with access to helicopters are limited, due in part to their high cost.

A medical helicopter trip costs thousands of dollars, the researchers say, which in most states is charged to insurance companies and consumers. In Maryland, Haider notes, each emergency transport by helicopter costs $5,000, and that cost is considered low because Maryland has a state-run emergency helicopter service. If all of the 65 significantly injured patients brought to a level 1 trauma center cited in the article’s calculations were transported by helicopter, the cost would be $325,000 in Maryland.

Haider says medical authorities need better guidelines for determining when to call for helicopter transport, to help first responders make life-and-death decisions on the scene. Helicopters may be overused, but for good reason — the possibility of making the mistake of not calling for a helicopter and watching a patient who might have survived die instead on the way to the hospital.

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