Comparison of mean on-scene times : road versus air transportation of critically ill patients in the Western Cape of South Africa

CITATION: Van Hoving, D.J., Smith, W.P. & Wallis, L.A. 2008. Comparison of mean on-scene times: road versus air transportation of critically ill patients in the Western Cape of South Africa. Emergency Medicine Journal, 25(3):136-139. doi:10.1136/emj.2007.051540.The original publication is available from http://emj.bmj.com/Background: The South African setting lends itself to the extensive use of air transport. There is a perception with healthcare providers that flight crews spend too much time with a patient before departure. The main advantage of aero medical transport is to minimise the delay to definitive care and prolonged on-scene time defies this objective. A study was carried out to examine the mean on-scene times of aero medical and road transport of critically ill patients in the Western Cape of South Africa. Methods: In this retrospective observational study, all critically ill patients transported in the Western Cape between September 2005 and May 2006 were evaluated. The mean on-scene time for each transport mode was calculated. Road transport was compared with air transport (rotor and fixed wing). Every transport mode was further divided into mission types: ‘‘scene’’ missions (scene to a healthcare facility) or ‘‘inter-facility’’ missions (from one healthcare facility to another). Results: A total of 7924 transports were included in the study, 7580 of which (95.7%) were road transports. The air transport group spent 53.2 min (95% CI 51.1 to 55.4) at the scene compared with 27.9 min (95% CI 27.5 to 28.4) for the road transport group. There was a significant difference between scene and inter-facility missions in the air transport group (mean 31.7 min for scene missions vs 58.7 min for inter-facility missions; p,0.001). A significant difference was also found in the road transport (mean 24.6 min for scene missions vs 31.9 min for interfacility missions; p,0.001). Conclusion: The on-scene time for transport missions by road is significantly less than for those done by air. There are significant differences between scene and inter-facility missions in both transport modes. Capacity building programmes with ongoing education and training of staff at referring facilities should be implemented.Publishers' versio