Air vs. Ground Evacuations: Which Saves More Lives And When?

In critical moments following a severe injury or sudden illness, the method of transportation to a healthcare facility can mean the difference between life and death. Whether you are evacuated by road or air ambulance, the evacuation process can play a significant role in trauma and medical response systems. Read on to learn more about which saves more lives when you need to evacuate immediately.

Understanding Medical Evacuation Systems

There are various factors that emergency response teams must consider when determining the most suitable mode of transport. In most cases, it involves careful consideration of factors such as injury severity, terrain, weather conditions, resource availability, and response time. Understanding the advantages, limitations, and appropriate uses of air and ground evacuation can help break down emergency response and highlight the challenges of saving lives for Affinity Rescue emergency response teams.

Medical evacuation refers to the emergency transportation of patients from the scene of an injury or illness to a hospital or from one medical facility to another. Trauma care relies on medical evacuation and rescue teams to provide support in cases of life-threatening events such as polytrauma, stroke, heart attack, or mass casualty incidents.

In every medical emergency rescue and evacuation situation, these are the two primary modes of transportation used:

• Road Ambulances: Typically staffed by paramedics equipped with basic to advanced life support tools.
• Air Ambulances: Usually, helicopters are staffed with highly trained critical care personnel, often including doctors, nurses, or flight paramedics.

Pros and Cons of Road Ambulances

Emergency medical service providers mainly use road ambulances for these reasons:

• Wider Availability: There are usually response teams who are often closer to the scene.
• Cost-Effective: They don’t cost as much as relying on air ambulances for every emergency.
• Weather Resilience: Not impacted by poor visibility, storms, or wind conditions.
• Stabilisation en route: They’re better suited for specific procedures due to less motion and vibration compared to helicopters.

However, they can also come with these challenges:

• Traffic and Infrastructure: Travel time can be slowed by traffic congestion, poor road conditions, or long distances in rural areas.
• Longer Transit Times: In time-critical emergencies, such as stroke or major trauma, even a few minutes of delay can be fatal.
• Resource Variability: Not all ambulances are staffed with the same level of medical expertise or equipped with advanced life support gear.

Pros and Cons of Air Ambulances

There are instances where you might be a victim of an emergency that requires a rapid response, and road ambulances are either delayed or unable to reach the location on time. This is when air ambulances are used to reduce the trauma risks associated with delays in receiving care at a hospital, especially for accidents that happen in rural areas. The main advantages of air ambulances include:

• Speed Over Long Distances: They significantly reduce travel time for efficient response rates.
• Access to Remote Locations: Air response teams can reach accident scenes that might be inaccessible by road.
• Advanced Medical Care: Air ambulances often carry advanced life support equipment and critical care specialists.
• Ideal for Interfacility Transfers: These may be required between rural hospitals and tertiary trauma centres, which are often located in cities, and travel time by road can increase the risk of complications.

Some challenges that can impact the decision to use air ambulances include:

• High Cost: Air evacuations can be costly if you don’t have proper emergency cover.
• Weather Reliance: Extreme weather conditions, such as poor visibility and strong winds, can ground helicopters until they are cleared, resulting in significant delays.
• Limited Capacity: There’s less space for patient movement, and it cannot support transporting additional equipment or accommodating patients who want to be accompanied by loved ones.
• Noise and Vibration: Conditions in flight can complicate specific medical interventions that could help stabilise complications before reaching a treatment facility.

The Types of Emergencies and Evacuation Processes

1. Trauma Patients

Research suggests that severely injured trauma patients transported by air have better survival rates, even when considering the severity of injuries. The reasons include that they provide faster access to definitive trauma care and advanced pre-hospital medical interventions.

2. Stroke and Cardiac Emergencies

Air ambulances can reduce delays in getting patients to specialised stroke centres capable of performing clot retrieval or thrombolysis. Moreover, patients with acute myocardial infarction (heart attack) may benefit from quicker transport to cardiac catheterisation labs.

3. Rural vs. Urban Areas

In rural areas, hospitals are often located at a distance from accident scenes, making air evacuation a preferred option to provide a prompt emergency response and prevent life-threatening outcomes. However, in urban areas, ground transport may be as effective because travel between facilities is faster when there are no traffic or weather delays.

4. Mass Casualty Events

In the event of natural disasters, such as floods or wildfires, or polytrauma cases resulting in multiple injuries, air ambulances can provide a rapid response. During mass casualty events, road ambulances may be overwhelmed or unable to access accident scenes.

What Determines the Evacuation Process?

Once the Affinity Rescue emergency centre receives an alert about a medical emergency, a decision must be made to dispatch either air or road ambulance services. These factors influence the approach:

• Glasgow Coma Scale if there’s a suspected brain injury.
• Potential blood pressure readings and signs of shock.
• How the injury happened and if there was violent force suffered, such as being thrown out of a moving car.
• The distance to a nearby medical facility with emergency trauma support to stabilise the patient in casualty.
• If ground response teams lack advanced medical equipment.

Air and ground ambulances, along with the evacuation processes that follow, are a necessity to support a complex emergency medical system. There’s no standard approach to determine which saves more lives. With Affinity Rescue, you can have peace of mind knowing that you have access to both, depending on the nature of the emergency you face.