Factors associated with non-optimal resource utilization of air ambulance for interfacility transfer of injured patients.

OBJECTIVE: Timely access to definitive care is associated with improved outcomes in trauma patients. The goal of this study is to identify patient, institutional and paramedic risk factors for non-optimal resource utilization for interfacility transfers of injured adult patients transported by air ambulance to a LTC.

METHODS: This is a retrospective cohort study of adult emergent interfacility transports via Ornge with data collected on patient demographics, clinical status, sending facilities, transport details and paramedic qualifications. A logistic regression model was used to analyze data.

RESULTS: 1777 injured patients undergoing transport with Ornge were analyzed with 805 of these undergoing non-optimal transport. Patients who had an optimal resource use were found to be older and mechanically ventilated. Risk factors increasing odds of non-optimal transport included patients transported from a nursing station (OR 1.94), transport with primary or advanced care paramedics (OR 6.57 and 1.44, respectively) and transport between both 0800-1700 and 1700-0000 (OR 1.40 and 1.54, respectively). The median delay to arrival to receiving facility if a patient had a non-optimal resource use was 40 minutes.

CONCLUSIONS: Three main risk factors were identified in this study. We believe that nursing stations as a sending facility and type of paramedics crew transporting patients resulted in non-optimal resource utilization primarily due to triage of lower acuity patients. However the timing of day is more likely to be a resource availability issue and something that can be further studied and potentially improved moving forward.