Mr David Ford1
1Edith Cowan University, Joondalup , Australia
Scope
In rural and remote Western Australia (WA) mortality from major trauma is up to four times higher than mortality rates from major trauma in the capital city, Perth. The routine bypassing of rural hospitals in favour of a Level 1 Trauma Centre for severely-injured patients in rural locations remains controversial. The Emergency Rescue Helicopter Service (ERHS) based in Perth, Western Australia (WA) operates in a zone from 50-250 km radius of Perth. There are 42 rural and regional hospitals within this zone.
Purpose
To determine whether helicopter-direct retrieval from an incident scene to a Level 1 Trauma Centre improves survival in severely-injured trauma patients in rural locations within 50–-250 km of Perth, compared to indirect retrieval whereby patients are transferred to a secondary hospital prior to transfer to a Level 1 Trauma Centre.
Method
Retrospective analysis (2006 – 2015 inclusive) of WA Trauma Registries for all major trauma patients transferred to a tertiary hospital in Perth and coronial data from the National Coronial Information System (NCIS) for all major trauma patients who were transported to one of the 42 rural hospitals in the zone around Perth but who died prior to transfer to a tertiary hospital.
Results
1429 major trauma patients were identified. The Direct helicopter patients had a larger proportion of road trauma cases and a higher median ISS (28 vs 24, p<0.001). There was a significantly increased risk of death (OR 1.45, 95% CI 1.01 – 2.19, p=0.044) in the Indirect group.
Conclusion
Direct helicopter retrieval from the incident scene to a tertiary hospital improved survival for major trauma patients in the 50-250km zone of Perth WA.
Biography:
David is the Course Coordinator of the Masters of Critical Care Paramedicine course at Edith Cowan University. He is a Critical Care Paramedic with over 20 years experience in Paramedicine including nine years as a Paramedic on the Western Australian (WA) Emergency Rescue Helicopter Service (ERHS). He is currently completing a PhD researching the helicopter retrieval of severely injured trauma patients from rural WA.