Cost-effective use of helicopters for the transportation of patients with burn injuries

We performed a retrospective review to analyze the use of helicopters for t he transportation of patients with burn injuries to determine whether a mor e cost-effective approach could be developed without impairing the quality or delivery of health care. Charts were reviewed for all patients with burn injuries who were transported by helicopter to our hospitals during a 2-ye ar period. Patients with inhalation injuries, with burn injuries received m ore than 24 hours before admission or more than 200 miles from our burn cen ter, with more than 30% total body surface area (TBSA) burned, or with asso ciated trauma injuries were excluded. Control patients with burn injuries w ho were transported by ambulance were identified and matched to the patient s with burn injuries transported by helicopter for the percentage of TBSA b urned, the percentage of third-degree burns, transport mileage, and age. Th e outcome was evaluated by comparison of length of stay, days on ventilator , and mortality rate. Comparisons were performed with Student t test. The t ransportation charge was determined for the patients transported by helicop ter who we believed were eligible for transport by ambulance. Forty-seven o f 85 patients transported by helicopter matched the inclusion criteria and had survived. There was no statistically significant difference between the percentage of TBSA burned, the percentage of third-degree burns, length of stay, days on ventilator, age, or transport mileage. There was, however, a significant difference in the time from the injury to admission to the hos pital, as well as in the charge for transportation. Patients who had less t han 30% TBSA thermal cutaneous injuries without evidence of inhalation inju ry, and who are less than 200 miles from a burn center may be safely transp orted by ambulance. Ambulance transportation may take additional time; howe ver, stricter protocols for helicopter transportation of patients with burn injuries will result in potentially substantial savings without affecting outcomes for patients.