Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-21T12:48:56.676Z Has data issue: false hasContentIssue false
  • English
  • Français

Role of Air-Medical Evacuation in Mass-Casualty Incidents—A Train Collision Experience

Published online by Cambridge University Press:  28 June 2012

Amit Assa ,
Dan-Avi Landau ,
Erez Barenboim  and
Liav Goldstein
Amit Assa*
Affiliation:
Israeli Air Force Surgeon General Headquarters, Tel-Hashomer, Ramat-Gan, Israel
Dan-Avi Landau
Affiliation:
Israeli Air Force Surgeon General Headquarters, Tel-Hashomer, Ramat-Gan, Israel
Erez Barenboim
Affiliation:
Israeli Air Force Surgeon General Headquarters, Tel-Hashomer, Ramat-Gan, Israel
Liav Goldstein
Affiliation:
Israeli Air Force Surgeon General Headquarters, Tel-Hashomer, Ramat-Gan, Israel
*
Mahane HilaPalmahim 76878Israel E-mail: amitassa@zahav.net.il
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

On 21 June 2005, a passenger train collided with a truck near Revadim, Israel.The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report.

Methods:

A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted.

Results:

The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision.Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The airmedical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time.

Conclusions:

Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region.This operation highlighted the necessity for flexibility in medical decision-making and the need for non-conventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.

Keywords

air-medical evacuationhelicoptermass-casualty incidentrescue teamstrain collision
Type
Case Study
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 3 , June 2009 , pp. 271 - 276
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rhee, KJ, Burney, RE, Mackenzie, JR, et al. : Therapeutic intervention scoring as a measure of performance in a helicopter emergency medical services program. Ann Emerg Med 1986;15:40–43.CrossRefGoogle Scholar
2.Burney, RE, Fischer, RP: Ground versus air transport of trauma victims: Medical and logistical considerations. Ann Emerg Med 1986;15:1491–1495.CrossRefGoogle ScholarPubMed
3.Frazer, R: Air medical accidents– A 20 year search for information. Air Med J 1999;Sept/Oct:34–39.CrossRefGoogle Scholar
4.Smith, JS, Smith, BJ, Pletcher, SE, et al. : When is air medical service faster than ground transportation? Air Med J 1993;Dec:258–261.CrossRefGoogle Scholar
5.Schiller, WR, Knox, R, Zinnecker, H, et al. : Effect of helicopter transport of trauma victims on survival in an urban trauma center. JTrauma 1988;28:1127–1134.Google Scholar
6.Gearhart, PA, Wuerz, R, Localio, AR: Cost-effectiveness analysis of helicopter EMS for trauma patients. Ann Emerg Med 1997;30:500–506.CrossRefGoogle ScholarPubMed
7.Baxt, WG, Moody, P: The impact of a rotorcraft aero-medical emergency care service on trauma mortality. JAMA 1983;249:3047–3051.CrossRefGoogle Scholar
8.Baxt, WG, Moody, P, Cleveland, HC, et al. : Hospital-based rotorcraft aeromedical emergency care services and trauma mortality: A multi-center study. Ann Emerg Med 1985;14:859–864.CrossRefGoogle Scholar
9.Burney, RE, Rhee, KJ, Cornell, RG, et al. : Evaluation of hospital based aeromedical transport programs using therapeutic interventions. Aviat Space Environ Med 1988;59:563–566.Google Scholar
10.Moylan, JA, Fitzpatrick, FT, Beyer, J, et al. : Factors improving survival in multisystem trauma patients. Ann Surg 1988;207:679–685.CrossRefGoogle ScholarPubMed
11.Schwartz, RJ, Jacobs, LW, Juda, RJ: A comparison of ground paramedics and aero-medical treatment of severe blunt trauma. Conn Med 1990;54:660–662.Google Scholar
12.Hotvedt, R, Kristiansen, S, Forde, OH, et al. : Which groups of patients benefit from helicopter evacuation? Lancet 1996;247:1362–1366.CrossRefGoogle Scholar
13.Urdaneta, LF, Miller, BK, Ringenberg, BJ, et al. : Role of an emergency helicopter transport service in rural trauma. Arch Surg 1987;122:992–996.CrossRefGoogle ScholarPubMed
14.Ammon, MA, Moore, EE, Pons, PT, et al. : The role of regional trauma system in management of a mass disaster: An analysis of the Keystone, Colorado chairlift accident. J Trauma 1988;28:1468–1471.CrossRefGoogle Scholar
15.Martin, TE: The Ramstein air–show disaster. J R Army Med Corps 1990;136(1): 19–26.CrossRefGoogle Scholar
16.Maningas, PA, Robison, M, Mallonee, S: The EMS response to the Oklahoma City bombing. Prehospital Disast Med 1997;12(2):80–85.CrossRefGoogle Scholar
17.Romundstad, L, Sundnes, KO, Pillgram-Larsen, J, et al. : Challenges of major incident management when excess resources are allocated: Experiences from a mass casualty incident after roof collapse of a military command center. Prehospital Disast Med 2004;19(2):80–85.CrossRefGoogle ScholarPubMed
18.Barbash, GI, Ribak, J, Revach, M, et al. : Management control of aero-medical evacuation systems. Aviat Space Environ Med 1988;59:172–175.Google Scholar
19.Jacobs, LM, Sinclair, A, Beiser, A, et al. : Pre-hospital advanced life support: Benefits in trauma. J Trauma 1984;24:8–13.CrossRefGoogle Scholar
20.Liberman, M, Mulder, D, Lavoie, A, et al. : Multi-center Canadian Study of pre-hospital trauma care. Ann Surg 2003;237(2):153–160.CrossRefGoogle Scholar
21.Rainer, TH, Houlihan, KPG, Robertson, CE, et al. : An evaluation of paramedic activities in pre-hospital trauma care. Injury 1997;28:623–627.CrossRefGoogle Scholar
22.Sukumaran, S, Henry, JM, Beard, D, et al. : Pre-hospital trauma management: A national study of paramedic activities. Emerg Med J 2005;22:60–63.CrossRefGoogle Scholar
23.Baxt, WG, Moody, P, Cleveland, HC, et al. : Hospital based rotorcraft aeromedical emergency care services and trauma mortality: A multi-center study. Ann Emer Med 1985;14:859–864.CrossRefGoogle Scholar
24.Hamman, BL, Cue, JI, Miller, FB, et al. : Helicopter transport of trauma victims: Does a physician make a difference? J Trauma 1991;69:3246–3250.Google Scholar
25.Burney, RE, Passini, L, Hubert, D, et al. : Comparison of aero-medical crew performance by patient severity and outcome. Ann Emer Med 1992;21:375–378.CrossRefGoogle Scholar
26.Rodenberg, H: The Revised Trauma Score: A means to evaluate aero-medical staffing patterns. Aviat Space Environ Med 1992;63:308–313.Google Scholar
27.Burney, RE, Hubert, D, Passini, L, et al. : Variation in air medical outcomes by crew composition: a two-year follow-up. Ann Emer Med 1995;25:187–192.CrossRefGoogle ScholarPubMed
28.Cameron, PA, Flette, K, Kaan, C, et al. : Helicopter retrieval of primary trauma patients by a paramedic helicopter service. Aust NZ J Surg 1993;63:790–797.CrossRefGoogle ScholarPubMed
29.Baxt, WG, Moody, P: The impact of a physician as part of the aero-medical pre-hospital team in patients with blunt trauma. JAMA 1987;257:3246–3250.CrossRefGoogle Scholar
30.Garner, A, Rashford, S, Lee, A, et al. : Addition of physicians to paramedic helicopter services decreases blunt trauma mortality. Aust NZ J Surg 1999;69:697–701.CrossRefGoogle ScholarPubMed
31.Bartolacci, RA, Munford, BJ, Lee, A, et al. : Air medical scene response to blunt trauma: Effect on early survival. Med J Aust 1998;168:610–615.Google Scholar