Helicopter or ambulance in interfacility transfers? Solving the dispatch dilemma. Experiences from the Padova EMS Base.

Background Emergency Medical Services working with ground and air ambulances often have to decide which is the most logistically adequate vehicle to send considering geographical and clinical parameters with large local variability. Available literature on the topic of helicopter-based interfacility transport is scarce, resulting in the possibility of allocating excessive or insufficient resources to missions. Aim of the study Helicopter-based transport is a resource intensive tool that is employed to manage conditions of geographical adversity, or critical clinical scenarios where warranting rapid centralisation of patients to higher levels of care. Evaluating with hard data at hand whether a transport is adequately manageable via ground or air ambulance makes the system more efficient in resource allocation, avoiding the risk of over- or undertriaging a mission. Materials and methods This observational retrospective study assesses data from UOC SUEM 118 Padova, the emergency medical services department of the University of Padua, in a timespan between January 2021 and July 2024. The dataset contains all interfacility transport missions via helicopter, and a pool of ground ambulance interfacility transports as a comparative measure. Data elaboration was managed via R software under the supervision of the Biostatistics, Epidemiology and Public Health Department of the University of Padua. Methods used include descriptive and association assessment, linear regression and change-point analysis. Results Under 44km (29% of the sample), ground ambulance superiority has been observed especially in light of the shorter activation times, uptake and delivery of the patient for this vehicle. Over this threshold, helicopter services are superior due to the faster travel times. Conclusions In a context such as Padua, where geography and road networks are not of hindrance to ground ambulance services, dispatch centres should not consider exclusively helicopters as the fastest response vehicle as this is an incomplete assumption. Consideration of travel distance should play a key role in logistic decision-making, in parallel with standing guidelines for clinical time-dependence.