Overview :

Use of helicopters or planes to deliver trauma victims to a hospital can be lifesaving. This method of transport should only be used when there are clear indications that justify the expense and risks involved.

General indications for using air medical transport:

(1) The patient has a serious injury either based on triage criteria or mechanism of injury

(2) Transportation by ground ambulance is difficult or prolonged.

Patients meeting triage criteria for evaluation at a trauma center:

(1) Trauma Score < 12

(2) Glasgow Coma Score < 10

(3) penetrating trauma to head, neck, chest, abdomen or pelvis

(4) spinal cord or spinal column injury producing paralysis of any extremity

(5) partial or total amputation of an extremity (excluding toes and fingers)

(6) two or more long bone fractures

(7) major pelvic fracture

(8) crushing injuries of head, chest or abdomen

(9) major burns especially with inhalation injury

(10) major chemical or electrical burns

(11) serious traumatic injury and patient < 12 years of age or > 55 years of age

(12) near drowning with or without hypothermia

(13) adult with systolic blood pressure < 90 mm Hg

(14) adult with respiratory rate < 10 or > 35 breaths per minute

(15) adult heart rate < 60 or > 120 per minute

Mechanism of injury:

(1) vehicle roll-over with unbelted passengers

(2) pedestrian struck by a vehicle traveling > 10 miles per hour

(3) fall > 15 feet

(4) motorcycle rider ejected at > 20 miles per hour

(5) multiple victims present

Difficult ground access:

(1) wilderness rescue

(2) ambulance unable to reach or leave site due to weather, road conditions or traffic

Long or distant ground transportation:

(1) time to trauma center by ground > 15 minutes

(2) time required to transport by ambulance to nearest medical facility is greater than the time to ship by air to a trauma center

(3) time required to extricate patient > 20 minutes

(4) no other medical transport available to the community if the ambulance is gone for an extended period of time

(5) local ambulance out of service or unable to deliver advanced life support

Cole JS. Chapter 10: Air medical and interhospital transport. pages 59-64. IN: Peitzman AB, Rhodes, M, et al. The Trauma Manual, Second Edition. Lippincott Williams & Wilkins. 2002.

National Association of EMS Physicians (NAEMSP). Air medical dispatch: Guidelines for trauma scene response. Downloaded from 06/06/2002. www.naemsp.org/Position%20Papers/AirMed/Dispatch.html