03 Reasons for secondary transfer of patients attended by a helicopter emergency medical service – a 1-year retrospective review using hospital episode statistics

<h3>Background</h3> Secondary transfer of critically unwell patients can be associated with delays to intervention resulting in increased risk of morbidity and mortality. This study exploited the Emergency Care Data Set (ECDS) and Hospital Episode Statistics (HES) to describe the proportion of patients treated by East Anglian Air Ambulance (EAAA) transferred within 24-hours of Emergency Department (ED) arrival; and to identify the reasons behind this. <h3>Methods</h3> Pseudonymised ECDS and HES data (01/04/2021 – 31/03/2022) were linked to a pseudonymised service patient record (HEMSbase 3.0, MedicOne Systems Ltd, UK). Patients attended by EAAA who were transferred to a second hospital facility within 24-hours of ED arrival were included. Data were collected on the reason against direct transfer and rationale behind secondary transfer. <h3>Results</h3> During the study period 1244 EAAA patients had an ED attendance in ECDS, of which 30 (2.4%) had a secondary transfer from ED within 24-hours. The largest proportion were trauma patients, often not meeting Major Trauma Triage Tool criteria prehospital but transferred following identification of complete injury burden in an ED. Some cardiac arrests could not be taken directly to a cardiac centre but were then transferred for coronary angiography. Neurosurgical patients were conveyed to an ED for diagnosis before an anticipated transfer. Full results are reported in table 1. <h3>Conclusions</h3> Early secondary transfer from ED is infrequent in patients attended by EAAA. These data identify factors influencing hospital disposition, limitations of trauma triage tools, and how system improvements could reduce treatment delays in neurological and cardiac arrest patient groups.