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Helicopter interventions at polytraumatized patients in

North-East of Romania

Diana Cimpoesu1,2, Claudia Bursuc2, Bogdan Zamfir2,3, Vladimir Makkai2

1University of Medicine and Pharmacy Gr.T.Popa Iasi

2Sf.Spiridon University Emergency County Hospital Iasi

3Dr.Iacob Czihac Military Emergency Hospital Iasi

Background: The polytraumatism is the third cause of death in all age group. The younger are

the most exposed to this. Romania is on the third place in Europe about deceases from car

accidents. It is easy to imagine that, depending on the magnitude of the accident, the distance

between the place of the event and the level of training available medical crews, time of arrival

of the first victims to hospital shows a great variety.

Objectives: Evaluation of the traumatized patients that were transported with the helicopter

from all the North-East region.

Methods: Retrospective study of the interventions of SMURD helicopter for polytraumatized

patients in the North-East Romania between March 2011 March 2013. North-East Romania has

30,949 km and 3.84 million inhabitants. It was intervened with an MI8 helicopter and a

Eurocopter135 helicopter, having mobile intensive care medical equipment, 2 pilots, 1

emergency physician and 1 nurse. This helicopter serves all the region, adults and children.

Results: The study considers 88 patients, average age 34,342,772 years, predominantly male(72%) and adults (68,2%).

The interventions were 29.5% primary (on site emergency response and transport victim to the

nearest competent hospital or patient in a medical unit of less than 3 hours) and 70.5% secondary

(intervention for transporting a critical patient hospitalized in a medical unit to another unit that

competence in solving case ).

Most interventions occurred in winter (38.6%) burns - and spring (27.3%) car accidents - and

during the week (62.5%). The largest number of helicopter interventions, were in the counties

Iasi (33%), Vaslui (29.5%) and Suceava (17%). Cases taken by ESA (air rescue crew) were

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directed to Iasi (76.1%) and the rest to Bucharest (especially burns and spinal medullar injuries).

A percentage of 3.4% of victims did not require transfer as intervention resulted in patient death.

The mean intervention in Iasi is 20 minutes by air compared to 45 minutes by road, for Vaslui

time is 30 minutes by air and by road of 80 minutes, for Suceava time is 45 minutes by air 120

minutes by road.

The predominant mechanism is burn trauma (26.1%) followed by car accidents (22.7%) and falls

from height (13.6%).

Brain injury (56,8% ) and chest trauma (27,2%) were the most common. The most common

combination was lesional brain injury and chest trauma and brain injury with severe trauma

limbs. Most patients did not require oro-tracheal intubation (56.8%) but were given large

amounts of fluid (1000 ml - 63.6%), major analgesics opioid (43.2%) and sedation (46,6%)

correlated with RTS (p