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For patients facing life-threatening trauma, the rapid arrival of advanced medical care can be the difference between life and death. Fresh data suggests that helicopter emergency medical services (HEMS) are quietly improving survival rates for severely injured individuals, exceeding statistical predictions. A recent analysis of nearly a decade of trauma cases in South East England reveals that these air ambulance teams may be saving more lives than previously understood.
The study, published in Emergency Medicine Journal, found that approximately five additional patients survive for every 100 treated for major trauma by HEMS. This translates to potentially 115 lives saved annually within the service’s typical caseload. While international research on the impact of HEMS has been hampered by inconsistent methodologies, this study offers compelling evidence of their effectiveness, particularly for those with a moderate to severe chance of survival.
Researchers at Air Ambulance Kent Surrey Sussex, South East Coast Ambulance Service NHS Foundation Trust, and Southampton University Hospitals NHS Trust analyzed data from 3,225 trauma patients who received pre-hospital care from a regional HEMS team between 2013 and 2022. They utilized a statistical method known as Ws analysis to estimate each patient’s probability of survival, accounting for injury severity and individual characteristics. This allowed them to compare predicted survival rates with actual outcomes.
The analysis revealed that 2,125 patients survived at least 30 days after their injury, representing an 85% actual survival rate compared to an expected rate of 81%. This improvement in survival was most pronounced among patients with severe injuries and a 25-45% predicted chance of survival, with 35% surviving beyond expectations. Even patients with a low probability of survival – less than 50% – showed a higher-than-predicted survival rate of 39%.
Factors Influencing Survival
Several factors were identified as contributing to improved survival rates. Younger age and a higher initial Glasgow Coma Scale (GCS) score – a measure of consciousness ranging from 3 to 15 – were strong predictors of unexpected survival. However, a key intervention linked to improved outcomes was pre-hospital emergency anesthesia (PHEA). PHEA, which involves placing patients into an induced coma, is a procedure only deliverable by advanced medical teams like HEMS and was independently associated with improved survival in severely injured patients (adjusted odds ratio 2.01, 95% CI 1.12 to 3.72, p=0.023).
Improving Outcomes in Traumatic Cardiac Arrest
The study also examined outcomes for patients experiencing traumatic cardiac arrest – when the heart stops beating after severe injury. Among 1,316 patients who suffered traumatic cardiac arrest, 27% (356 patients) regained circulation while being transported to the hospital. Of those who initially survived, 25% were still alive after 30 days. Notably, the likelihood of circulation returning increased by 6% each year between 2013 and 2022, suggesting improvements in pre-hospital care are having a measurable impact.
Researchers caution that their findings demonstrate higher-than-predicted survival rates, but do not definitively prove that HEMS caused the improved outcomes. They acknowledge that assumptions about consistent patient characteristics and service performance over time may not always hold true. However, they emphasize the potential clinical benefit, aligning with previous research demonstrating the economic and social benefits of HEMS. SciTechDaily reported on the findings, highlighting the potential impact of these services.
The study’s authors conclude that their findings provide supportive evidence for continued investment in HEMS, particularly for severely injured patients. They also emphasize the necessitate for further research, including comparative studies with alternative care pathways, to establish a definitive causal link between HEMS attendance and improved survival rates. Further details of the study are available in the Emergency Medicine Journal.
As HEMS continue to evolve and refine their practices, ongoing research and investment will be crucial to maximizing their life-saving potential. The future of trauma care may well depend on the continued development and accessibility of these vital services.
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Disclaimer: This article provides informational content and should not be considered medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of any medical condition.
