Comparing rural ground and air EMS: A Level 1 Trauma Center's experience

Introduction: There is no recent review of ground versus air transport in the rural environment. Rural Emergency Medical Services (EMS) and trauma systems are rarely evaluated in the literature. This Level I trauma center used in this review is located in the northeast in a rural area. It is serviced by one helicopter and several ground services. The time period studied was 2003 to 2008.

Methods: We sought to compare the differences in ground and air EMS for patients transported directly from the location of their injury. The differences examined included age, gender, vital signs (pulse, blood pressure (BP), and respirations), Glasgow Coma Score (GCS) and its components, survival to discharge, discharge location, hospital, ICU, and ventilator days, time in the Emergency Department (ED), Revised Trauma Score (RTS) and Injury Severity Score (ISS). Student's t-tests were used to determine the differences in continuous variables. Categorical variables were displayed using various techniques.

Results: Trauma patients using ground services were older. Both pulse and respiratory rate were significantly higher in the air group, blood pressure was not. All components of the GCS in the air patients were lower than the ground. Hospital days were higher in air patients, while the ED minutes were lower. Air patients had higher ISS then the ground. The RTS, as expected, was lower in the air transported patients.

Conclusions: There are significant differences in the markers of physiology such as vital signs and expected survival, ISS between air and ground patients transported from the field.