Helicopter Transport of Trauma Patients Continues to be Overutilized: A Call for Universal Transport Criterion

BackgroundHelicopter emergency medical services (HEMS) provide rapid transport for trauma patients to specialized centers, potentially improving outcomes in life-threatening situations. However, HEMS is costly and often overutilized, with limited benefit in low-acuity cases. This study re-evaluates HEMS utilization at our Level I trauma center to assess current appropriateness based on clinical need and validated triage criteria.MethodsWe retrospectively analyzed all trauma patients transported to our institution by helicopter from January 2018-December 2021. Patients were categorized into trauma activation criteria and if any procedural intervention was performed within 1 hour of transport. Of the patients that received a procedure during admission, type of procedure and specialty that performed the procedure were evaluated. Disposition from trauma bay was collected.Results1419 helicopter transports met inclusion criteria during our analyzed time frame. 37.8% (n = 536) required a procedural intervention during their admission. Only 1.5% of patients (n = 21) who received an intervention were treated within 1 hour of arrival. Less than 30% of patients met criteria for helicopter transport when evaluated with current established national guidelines for prehospital triage. 35% of patients required ICU admission, while 8% were discharged to home within 24 hours. 36.3% (n = 515) of patients were activated as a Level I trauma alert upon arrival.ConclusionsMost helicopter transports were not clinically justified based on urgency or national triage guidelines. These findings highlight persistent overuse of HEMS and reinforce the need for standardized, evidence-based criteria to guide both scene and interfacility helicopter transport decisions in trauma care.