Study of multiple rotor-wing flight programs on emergency medical services

Abstract Introduction: Improvements in prehospital care, designation of trauma centers and expeditious transport have significantly reduced trauma deaths. In 1985 Pennsylvania formally introduced trauma-system implementation, including the integration of regional prehospital trauma guidelines. The purpose of this study is to examine the similarities and dissimilarities of advanced life support (ALS) trauma operations in eastern Pennsylvania and southern New Jersey, and the impact and integration of multiple flight programs on regional ALS systems. Setting: Ground ALS (GALS) operations within Pennsylvania and New Jersey, and air medical operations in Pennsylvania. Methods: Site visits and telephone interviews were used to characterize demographic, operational and clinical practice characteristics, including those flights where GALS was on location. Descriptive statistics were used to compare the various programs. Results: Airway management differed greatly among the respondents. For example, of five air medical services, one did not carry paralytic agents, and one performed oral intubations only after the use of such agents. None of the GALS services used such agents. Procedures that required direct physician orders varied among the flight programs and the GALS services. Trauma triage guidelines following the American College of Surgeons recommendations were modified by all GALS services. Conclusions: Wide variation in the scope of practice exists among air medical services and GALS services within New Jersey and Pennsylvania.