A review of the burns caseload of a physician-based helicopter emergency medical service / Karina Hall, Brian Burns

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Objectives: The aim of this study was to describe patient demographics, injuries, physiology and interventions performed by retrieval physicians in the care of burns patients in both a pre-hospital and interhospital setting.
Methods: A retrospective review of patient records from a large Australian Helicopter Emergency Medical Service was conducted. Demographics, injury, burn type, physiology and intervention data were extracted into a database for statistical analysis. Basic descriptive statistics were calculated, and patient physiology measures were compared at arrival and destination.
Results: A total of 490 burns cases were identified from a 5 year period (January 2010–August 2015). The majority (78.6%) were interhospital transfers conducted by road (49.4%) or helicopter (36.9%). Patients were predominantly men (75.7%) with a median age of 37 years (interquartile range [IQR] 23–50). Median estimated total body surface area burned was 15% (IQR 8.5–20) and
18% (IQR 10–30) in pre-hospital and interhospital groups, respectively; however, retrieval physicians tended to overestimate total body surface area burned in comparison to destination burns units. Flash burn or explosion were the predominant aetiology of burn (49.4%), although the majority (95.3%) of patients had no associated traumatic injuries. Sixty patients were intubated by the Service. Escharotomies were performed on eight occasions resulting in improvement in circulation or ventilation. Overall mortality
was 3.7% at 24 h.
Conclusions: The Service cares for 80–100 burns patients annually, a proportion of whom require complex interventions such as intubation and escharotomy, which was performed by retrieval physicians appropriately.
Associated traumatic injuries were infrequent in patients who sustained burns from flashes or explosions.