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Pediatric Emergency Air Transports (PEATs) at Massachusetts General Hospital, Boston, Massachusetts, were reviewed between November 1986 and December 1987. Severity of illness, complications, and outcome of PEATs were compared with ground transports. Factors associated with PEAT survival were identified.
Severity of illness was measured using a modified Denver Patient Status Category (DPSC) method and the Therapeutic Intervention Scoring System (TISS). There were 35 PEATs (30 helicopter, five fixed-wing) and 96 ground transports.
Mean severity of illness for patients was greater in PEAT than for the ground transport (PEAT DPSC score=4.23±1.06 versus ground DPSC=3.57±0.89 [SD], p=.0005). The PEAT mortality was associated with a greater mean severity of illness (TISS survivors=19.1±11.4 versus non-survivors=44.3±9.5, p=.0001), but not with: the presence of an in-flight physician; transport delay; transport duration; age; sex; history of chronic illness; or intra-transport medical complication.
Compared to ground transports, PEATs were used for higher risk patients.
Multiple trauma is the leading cause of death of all Americans below the age of 37. The estimated cost to American society is between 70 and 80 billion dollars per year. In our present day society, one person in four will require the use of a trauma facility during his or her lifetime. Several studies have now been performed to demonstrate that the management of trauma is woefully inadequate. Stemming from the classical studies of Trunkey, Lim and West comparing San Francisco with Orange County, California; it was demonstrated that approximately 30% of fatalities resulting from traumatic injury were preventable in Orange County as compared to an extremely small percentage in San Francisco which does have a designated trauma center. Recent advances in the management of head injury may further increase this salvageable percentage.
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