FACTORS INVOLVED IN EMERGENCY MEDICAL SERVICE HELICOPTER OCCUPANT CRASH SURVIVAL

Since the first hospital-sponsored emergency medical service (EMS) helicopter transport program began in 1972, more than 846,000 patients have been transported by helicopter, the majority since 1980. During the same period, 84 EMS helicopters were involved in crashes. The National Transportation Safety Board (NTSB) evaluated 59 EMS helicopter crashes occurring during the period 1980 to 1986. The NTSB found, among other things, that in numerous EMS helicopters the interior was not modified to the applicable FAA standards for crashworthiness or good engineering practices. Injury outcomes for EMS helicopter occupants and those in air taxi helicopters are compared. NTSB crash records were reviewed and survivors surveyed to determine occupant injury experience. It was found that occupants of EMS helicopters were more likely to be seriously injured in a survivable crash than those in the comparison population (relative risk = 2.10, 95% CI 1.21 < RR < 3.64, p < 0.008). Forty-two percent of the injured EMS helicopter survey respondents identified medical equipment or components as a factor in their injury compared with just 3% of the injured comparison population when asked about the helicopter interior and their injury causation. Twenty-three percent of the EMS helicopter passengers experienced serious head injuries, a level twice as large as any other group in the study. Opportunities exist to reduce the exposure of EMS helicopter occupants to serious injury during the design and modification of the helicopter interior for the EMS patient care mission.