The effects of air ambulance admissions on orthopaedic trauma services in a single hospital

Emergency air ambulance admissions to the authors' hospital have increased five-fold from 18 in 1992-1993 to 92 in 1998-1999. The service implications for hospitals receiving air ambulance admissions is unknown. Aim: An audit/analysis of all emergency air ambulance admissions to the authors' hospital between August 1998-July 1999. Method: Admissions identified from computer records. The case notes were then retrospectively analysed. Data was collected on accident location, admitting speciality, number of orthopaedic procedures and their operative time, and length of inpatient stay. Results: There were 92 patients brought in by air ambulance. Hospital notes were available for 82 and a further 8 had A&E case notes only available for analysis. A total of 34 (38%) were admitted under the orthopaedic surgeons, 28 (31%) under the neurosurgeons, 10 (11%) under the plastic surgeons, 2 (2%) under the general surgeons and 2 (2%) under the physicians. Nine patients were discharged home from the A&E department, two died in A&E and five were transferred to other hospitals. Four of the neurosurgical patients needed orthopaedic input. The admitted patients required 122 orthopaedic procedures taking 120 h of theatre time. The total orthopaedic inpatient stay was 628 days, of which 145 days were in the intensive care or high dependency units. A total of 28 (80%) of the orthopaedic patients came from outside the hospital's catchment area. Conclusions: Admissions by air ambulance place a high demand on orthopaedic services and often originate from outside the hospital's catchment area. Additional resources may be required by hospitals receiving trauma patients by this route. (C) 2002 Elsevier Science Ltd. All rights reserved.