US Army air ambulance operations in El Paso, Texas: A descriptive study and system review

Objective: Analysis of a high-volume military air ambulance unit and review of the U.S. Army air medical transport system and Military Assistance to S afety and Traffic (MAST) program. Setting: A remote medical system with num erous ground emergency medical services, Inclusion: All patients transporte d between January 1, 1996, and February 28, 1998, Exclusion: Patients who w ere dead on the scene or for whom records were unavailable, Methods: Retros pective review of transport and available inpatient records. Results: A tot al of 517 patients were transported during the study period; 461 patients m et the inclusion criteria (89%). Of these, 70% were classified as trauma pa tients, and 30% had medical or other surgical diagnoses. Prehospital respon ses accounted for 71.6% of transports, and 28.4% were interhospital transfe rs, Missions averaged 23.4 minutes per flight, with no major aircraft misha ps. Prehospital utilization review showed appropriate use; 35% of interhosp ital trauma missions and 11% of interhospital nontrauma missions were staff ed inadequately by our criteria. Time intervals, procedures, and program im pact are discussed. Conclusion: This and similar units participating in the MAST program provide effective air transport in settings underserved by ci vilian programs. Quality and wartime readiness could be improved by central ized medical direction, treatment and transfer protocols, and enhanced trai ning of medics. Further investigations of the clinical impact of advanced t raining and a two-medic aircrew model are warranted.