Comparing rural ground and air EMS transport using national level data

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. The data for this study was from the National Trauma Data Set (NTDS) calendar year 2007. A variety of trauma centers (166) submitting data to the NTDS with patients (n=10,885) transported by air or ground from rural scenes. 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), and Injury Severity Score (ISS). Student's t-tests were used in continuous variables. Categorical variables were displayed using various techniques. Results: Trauma patients using ground services were older than those by air. The patient's pulse was significantly higher, while the blood pressure was lower. All components of the GCS in the air patients were lower than the ground patients. Scene time for air patients was longer while total EMS time for air patients was shorter. Hospital days were higher in air patients, while the ED minutes were not significantly different. Air patients had higher ISS then the ground. 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.