POLYTRAUMA - COMPARISON OF THE CLINICAL COURSE FOLLOWING TRANSFER BY AIR (WITH EMERGENCY PHYSICIAN) VERSUS BY LAND (WITHOUT EMERGENCY PHYSICIAN)

We analyzed the influence of initial intensive care at the accident si te performed by an emergency physician and followed by helicopter tran sport on the course during hospital stay in patients with multiple tra uma. We therefore compared the dates of 107 patients transported by th e swiss air rescue (REGA) and an emergency physician with 131 patients transported by an ambulance and paramedic staff. By similar case mate rial the REGA-patients showed a higher injury severity grade. Mortalit y of the REGA-patients was significantly higher (21%) than of the ambu lance-patients (10%), but length of stay was significantly shorter and morbidity identical. We suspect, that the higher mortality of the REG A-patients is explained by the large number of surgically non treatabl e severe traumas. None of the REGA-patients arrived at hospital with c irculatory insufficiency whereas 4 of the ambulance-patients were in s tate of shock. We assume that first of all primary treatment of the sc ene of injury by an emergency physician and eventually also transport by helicopter have a positive effect on the course of patients with mu ltiple trauma during hospital stay.