Racial Disparities in Emergency Helicopter Transport for Trauma Patients

Author: American Society of Anesthesiologists
Published: 2024/10/20
Publication Type: Reports & Proceedings
Peer-Reviewed: Yes
Topic: Air Ambulance Services - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: Black, Asian, and Hispanic trauma patients less likely to get lifesaving helicopter transport, finds first-of-its-kind study.

Why it matters: This article reveals a concerning disparity in access to critical medical care based on race and ethnicity. The study, conducted by researchers at the University of Rochester Medical Center, found that Black, Asian, and Hispanic trauma patients were less likely to receive potentially lifesaving helicopter transport to trauma centers compared to white patients. This finding is particularly important because it highlights a systemic issue in emergency medical services that could be contributing to poorer health outcomes for minority groups. The research provides valuable insights into healthcare inequities and underscores the need for further investigation into the reasons behind these disparities, as well as the development of strategies to ensure equitable access to emergency medical transportation for all patients regardless of their racial or ethnic background - Disabled World (DW).

Introduction

Severely injured Black, Asian and Hispanic children and adults are less likely than white patients to receive critical helicopter ambulance services, which can make the difference between life and death, according to a study presented at the ANESTHESIOLOGY® 2024 annual meeting. It is the first to highlight disparities in the use of helicopter ambulance transport after severe trauma.

Main Item

"Severely injured patients are more likely to survive if they get the right care within the 'golden hour,' the critical first hour after the trauma," said Christian Mpody, M.D., Ph.D., lead author of the study and anesthesiology resident at Montefiore Medical Center, New York. "The reality is that current efforts to expand helicopter ambulance programs have yet to result in equitable care for patients of different races and ethnicities."

Traumatic injuries, such as those from vehicle or fall-related accidents and violent attacks, are a leading cause of death in the United States among children and adults. Patients with serious injuries who require urgent surgery or admission to the intensive care unit (ICU) should be taken to a hospital that provides the highest level of trauma care. Usually, the decision to dispatch helicopter transport is based on the information received about the patient during the 911 call. A priority level is then assigned along with a response to dispatch air or ground emergency medical services (EMS) transport. Additionally, non-medical factors can influence the decision, such as weather conditions and the availability of a helicopter, but race and ethnicity should not be among them, said Dr. Mpody.

Researchers assessed hospital transport records for 307,589 adults and 42,812 children who had a severe life-threatening injury and required urgent surgery or ICU admission between 2017 and 2022. They used data from the National Trauma Data Bank, which is based on more than 7.5 million records from more than 900 U.S. trauma centers. They separately analyzed trauma patients who were not injured within 15 miles of the receiving hospital to ensure that their findings were not mostly explained by a subgroup of patients who sustained trauma near a hospital, which would eliminate the need for helicopter transport. They also ruled out other possible reasons for the difference, such as lack or type of insurance and severity of injury.

Overall, they found transport via helicopter ambulance was associated with a statistically significant higher rate of survival: 82.4% of patients transported by helicopter ambulance survived vs. 80.6% of those transported by ground ambulance.

They also found statistically significant evidence that race and ethnicity play a role in whether a trauma patient received helicopter transport - particularly among Black patients - and determined that the numbers didn't improve over the five years of the study. Overall:

• White adults were twice as likely to be air transported compared to Black adults (25.4% of white adults were air transported vs. 12.6% of Black adults, 13.5% of Asian adults and 15.9% of Hispanic adults).
• White children were 50% more likely to be air transported compared to Black children (33.6% of white children were air transported vs. 20% of Black children, 22.4% of Asian children and 24% of Hispanic children).

The researchers recommend a multifaceted system-wide approach to address the racial and ethical disparities in helicopter transport, including:

• More closely adhering to evidence-based triage scores to help identify which trauma patients would benefit most from helicopter transport, reducing the chance that race or ethnicity would influence the decision.
• Reinforcing structured communication protocols to help EMS providers make unbiased decisions about the need for helicopter transport.

"We need to keep collecting and analyzing data to better understand and fix disparities in trauma care," said Dr. Mpody. "By doing this, we can identify service gaps and develop targeted solutions. When it comes to disparities, we need to do the opposite of 'see no evil, hear no evil, speak no evil' - we must see it, hear it and speak out to fix it."

American Society of Anesthesiologists (ASA)

Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 58,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by American Society of Anesthesiologists and published on 2024/10/20, this content may have been edited for style, clarity, or brevity. For further details or clarifications, American Society of Anesthesiologists can be contacted at asahq.org NOTE: Disabled World does not provide any warranties or endorsements related to this article.