Use of Fixed-Wing Modified Scene Air Ambulance Responses for Injured Patients in Northern Ontario: A Pilot Study

Use of fixed-wing modified scene air ambulance responses for injured patients in Northern Ontario: A pilot study

Introduction:  This project began as an effort to improve trauma response for patients in Northern Ontario.  Using existing response systems we can improve timely access to care.

Objective: Timely access to a lead trauma hospital (LTH) saves lives; however, the vast geography of Northern Ontario creates a barrier to equitable access to an LTH. Paramedics in Ontario follow the Field Trauma Triage Standard (FTTS) to identify which patients should be directly brought to an LTH. A pilot project was launched using a fixed-wing modified scene response (MSR) to transport patients from Northern Ontario who met the FTTS directly to an LTH. This study aimed to: 1) explore the impact of the fixed-wing MSR pilot program on the time to LTH arrival for injured patients in Northern Ontario compared to the traditional interfacility transfer (IFT) process, and 2) determine the frequency and specific FTTS criteria that were fulfilled. 

Methods: This was a retrospective cohort study of injured patients in Northern Ontario who were emergently transported to an LTH by Ornge between January 2016, and October 2021. Electronic patient care records were manually reviewed and patient cases were grouped by their sending and receiving facilities to evaluate time differences between MSR and IFT.

Results: For same-distance transports, the average time from injury to trauma center arrival was reduced with MSR (292.8 minutes) compared to IFT (507.8 minutes), with a mean difference of 130.3 minutes. All MSR and 90% of IFT cases met at least one FTTS criterion.

Conclusion: Fixed-wing MSR improves access to timely definitive care for injured patients in Northern Ontario, and all patients transported in this pilot project met trauma bypass criteria.