Population coverage increases, nonlinearly, as MGT decreases.Īccess to specialist care-and access to trauma centers, in particular-is an important and contentious issue. Population coverage for helicopter access to Level I and II centers is less and reduced even further when only Level I centers are considered. Population coverage for helicopter access to Level I, II, or III trauma centers in Alabama is almost universal, regardless of MGT duration. This study has examined the effect of MGT on population coverage. The aim of this project was to evaluate the impact of varying MGT on population coverage, using the state of Alabama as a case study. The impact of MGT duration on population coverage is likely to be nonlinear, as the distribution of the population is highly clustered, rather than uniform. MGT, which includes both the time required to get the helicopter airborne, as well as time spent at the scene, packaging and loading the casualty into the aircraft-cuts into the 60 min and reduces the number of residents, by reducing the size of the ellipse, who can reach a trauma center within this time frame. The clock starts with the receipt of the call by the aeromedical retrieval team. In addition, these evaluations must consider the “mission ground time” (MGT). This ellipse is central to evaluating the population coverage of aeromedical retrieval networks and accessibility of trauma systems. The resulting area (and therefore population) from which patients can be taken to a trauma within a set time is described by an ellipse. If more time is spent flying to the casualty, then less time is available to take the patient to the trauma center. In most trauma systems, helicopters are only called once the casualty has been assessed by a ground-based emergency medical service (EMS) crew, and the aircraft has to fly to the scene before it can take the patient to hospital. Using helicopters to improve accessibility is not without problems. 6 Each year, approximately 400,000 medical retrieval flights take place in the United States, 7 and helicopter transport is often viewed as critically important by communities. First used during the Korean war, aeromedical transport has become a key component of civilian emergency care systems. Helicopters are a recognized means of extending this geographical envelope and improving access to specialist trauma care. The accessibility of a trauma center is often measured in terms of the number or proportion of residents who can reach such a center within a set time-typically 60 min. 1 The time to definitive care is an important predictor of survival, 2– 5 and trauma systems are designed to maximize the number of people who have access to such specialist care. Trauma is a major cause of morbidity and mortality in patients aged <46 y.
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