A university-staffed, private hospital-based air transport service. The initial two-year experience

J. H. Duke Jr and W. P. Clarke

During the first two years of a cooperative effort between the University of Texas Medical School at Houston and Hermann Hospital, Houston, a program designed to extend the emergency center to the patient by helicopter treated and moved 1,702 patients. A physician and flight nurse attended patients on each mission. Of all flights, 68.3% were because of major multiple trauma and 28.8% were to the scene of an accident. The magnitude of these injuries was reflected by a mortality of 11% at the scene of the accident and 7% in the emergency room of those transported. The primary purpose of the program is to minimize the time between the catastrophic event and the institution of appropriate medical therapy. Our experience with this program of early stabilization and rapid transport has led to the following observations: (1) single-organ injury is virtually nonexistent in the patient with multiple trauma; (2) clotting abnormalities, even disseminated intravascular coagulopathy, are seen regularly in patients with apparently isolated head injuries; and (3) patients with apparently isolated head injuries often have serious pulmonary function abnormalities.