Burns : journal of the International Society for Burn Injuries · 2026
Burn injury management by Dutch physician-staffed HEMS: Findings from the HEMS-BURNS cohort and National Trauma Registry.
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Vianen Niek J, Van Lieshout Esther M M, Van der Vlies Cornelis H, Maissan Iscander M, Verhofstad Michael H J, Van Vledder Mark G
Аннотация
INTRODUCTION: Dutch Physician staffed Helicopter Emergency Medical Services (P-HEMS) are regularly dispatched to provide care to patients with burns on scene. It is unclear if and which patients with burns benefit from P-HEMS care. This study aimed to investigate P-HEMS dispatch and cancellation rates, intervention rates, and patient outcomes in burn care.
METHODS: This was a descriptive retrospective cohort study. Databases of the Rotterdam P-HEMS and the Dutch National Trauma Registry (NTR) were consulted for burn cases between January 1, 2015, and December 31, 2023. Data on cancellation, patient characteristics, burn severity and type, prehospital treatment, transportation, treatment times, and mortality were collected and analyzed.
RESULTS: Rotterdam P-HEMS was dispatched 976 times for suspected burn injuries, with 455 (46.6%) dispatches being cancelled, mainly due to minor injuries (n = 288; 63.3%). Of 521 non-cancelled dispatches, most involved adults (n = 345; 66.2%) and flame burns (n = 248; 59.6%), while pediatric patients mostly had scald burns (n = 123; 81.5%). P-HEMS specific interventions were performed in 33.6% of non-cancelled dispatches, with a significantly lower rate in children than in adults (14.2% vs 43.5%; p < 0.001) and a significantly lower rate for scald burns than for flame burns (14.6% vs 45.6%; p < 0.001). Of 879 patients with burns with HEMS involvement recorded in the NTR, median Injury Severity Score (ISS) was 9 (P25-P75 1-25), median hospital length of stay (HLOS) was 5 days (P25-P75 2-21 days), ICU admission occurred in 465 of 879 cases (52.9%), and in-hospital mortality was 13.7% (n = 120).
CONCLUSION: This retrospective cohort study found that 46.6% of P-HEMS dispatches for patients with burns were cancelled, often due to minor injuries. P-HEMS-specific interventions were performed in 33.6% of non-cancelled dispatches. These findings suggest a need to optimize dispatch criteria to reduce overtriage and improve efficiency of P-HEMS dispatch for burn care.
METHODS: This was a descriptive retrospective cohort study. Databases of the Rotterdam P-HEMS and the Dutch National Trauma Registry (NTR) were consulted for burn cases between January 1, 2015, and December 31, 2023. Data on cancellation, patient characteristics, burn severity and type, prehospital treatment, transportation, treatment times, and mortality were collected and analyzed.
RESULTS: Rotterdam P-HEMS was dispatched 976 times for suspected burn injuries, with 455 (46.6%) dispatches being cancelled, mainly due to minor injuries (n = 288; 63.3%). Of 521 non-cancelled dispatches, most involved adults (n = 345; 66.2%) and flame burns (n = 248; 59.6%), while pediatric patients mostly had scald burns (n = 123; 81.5%). P-HEMS specific interventions were performed in 33.6% of non-cancelled dispatches, with a significantly lower rate in children than in adults (14.2% vs 43.5%; p < 0.001) and a significantly lower rate for scald burns than for flame burns (14.6% vs 45.6%; p < 0.001). Of 879 patients with burns with HEMS involvement recorded in the NTR, median Injury Severity Score (ISS) was 9 (P25-P75 1-25), median hospital length of stay (HLOS) was 5 days (P25-P75 2-21 days), ICU admission occurred in 465 of 879 cases (52.9%), and in-hospital mortality was 13.7% (n = 120).
CONCLUSION: This retrospective cohort study found that 46.6% of P-HEMS dispatches for patients with burns were cancelled, often due to minor injuries. P-HEMS-specific interventions were performed in 33.6% of non-cancelled dispatches. These findings suggest a need to optimize dispatch criteria to reduce overtriage and improve efficiency of P-HEMS dispatch for burn care.