- Ground transport times > 30 minutes from time of arrival at patient.
- Remote or rugged terrain or ambulance transport impeded by road conditions or traffic.
- Using ground ambulance would leave the local community without ambulance coverage.
- Mass casualty incidents.
- Need for diagnostic testing not available locally.
- When time is critical to survival:
- Trauma history:
Rollover or ejection from vehicle
High speed collision
Prolonged extrication > 15 minutes
Death of an occupant in the same car
Extensive deformity of the INTERIOR of the car
Car-pedestrian accidents
Multiple victims
Falls greater than 2 times the patient's height
Penetrating injury to the head, chest or abdomen
Extremity amputations
Near drowning - Physical Exam:
Glascow coma score less than 12 or CRAMS 8 or less, skull penetration or CSF leak
Respiratory rate > 30 or < 10 and/or a need for airway intervention
Systolic B/P <90, HR <50 or >120 (in adult)
Major chest wall, abdominal or pelvic injury (any trauma involving two or more organs)
Two or more extremity fractures
Spinal cord injury
Burns > 15% or airway involvement - Medical History:
Chest Pain
Respiratory distress
Signs of stroke
Uncontrolled seizures
Shock of any kind
Coma of unknown cause