Abstract
Introduction: With New Zealand's South Island classified as 80% mountainous terrain, inter-hospital air ambulance transport is necessary to ensure patients can have the most appropriate specialist treatment. Christchurch Air Retrieval Service (CARS) transports urgent or critical patients from smaller hospital facilities who require a higher level of care, with or without intensive care interventions. Other transport reasons include relocating or returning patients to their domicile DHB after an admission or specialist treatment or relocating patients to areas with available bed spaces. The transport crew consists of an experienced intensive care flight nurse with or without an intensive care registrar. Less frequently, also utilised are other specialist services such as midwives, paramedics, paediatric, obstetric, surgical, anaesthetic or intensive care specialists.
Aim: To analyse and describe the CARS inter-hospital workload, over a 10-year period, to develop an epidemiological profile of the CARS' patients and describe the services provided for this population.
Method: A simple, descriptive, retrospective study design was selected for this research. This included the analysis of an electronic dataset, from 1st January 2008 to 31st December 2017, which was originally collected for purposes other than this research.
Results: Over the ten-year study period, CARS completed 4365 inter-hospital patient transports. An increase in inter-hospital patient transports from 1.04 patients per day to 1.81 patients per day was seen over the study period, with the transport requests noting a similar increase. The average duration for each transport was 5 hours 34 minutes, and the most frequent transport crew was 'doctor and flight nurse', with a clear trend towards more 'flight nurse only' transports in the later study years. The majority of patients were brought to Christchurch Hospital and Christchurch Women's Hospital. The most frequently recorded mode of transport was that of fixed-wing aircraft, at 82.0% (n= 3570), helicopter transports were used on average 13.8% (n=595) of the time and road transports accounted for a mere 4.2% (n=198) of the workload. Despite this, helicopter and road only transports were more urgent in nature. Most transport missions started between 07:00 hrs and 14:59 hrs (68.2%, n=2971), and overall transport urgency has increased over the ten year study period. The most frequent medical reason for patient transport was cardiology services at 18.1% (n=789) followed by those needing ICU services at 16.2% (n=707).
Conclusion: The workload of CARS is increasing, and patient's inter-hospital transport needs continue to become more urgent. Continuation and expansion of the data collection and further examination of the transport information discussed is required to fully evaluate future service requirements.