Air ambulance transfer of adult patients to a UK regional burns centre: Who needs to fly? Elizabeth Chipp *, Robert M. Warner, David J. McGill, Naiem S. Moiemen Midlands Adult Burns Centre, University Hospital Birmingham, Raddlebarn Rd, Birmingham B29 6JD, United Kingdom 1. Introduction Helicopter emergency medical services play a valuable role in the transfer of critically ill and injured patients but their use is limited by cost, number of available aircraft and restricted flying hours. There are currently no standardised callout criteria and no agreement on the use of air ambulances for the transport of burn injured patients within the United Kingdom and the potential exists for under utilisation or inappropriate use. This paper reviews the role of air ambulance services in the provision of regional burns care and suggests guidelines for their use in order to maximise benefit and reduce associated risks and costs. 1.1. Background Helicopters were first used to transport casualties in the Vietnam and Korean wars [1] and since then have become a valuable part of the emergency services for the transfer of patients with trauma and serious medical conditions. Heli- copter Emergency Ambulance Services (HEAS) began operat- ing in England in 1987 and there are now 30 aircraft operating in the United Kingdom flown by 18 different air ambulance services. Each of these services is run as an independent charitable organisation with variable amounts of funding from central government. The Midlands Adult Burns Centre is based at University Hospital Birmingham and serves a population of 5.5 million burns 36 (2010) 1201–1207 article info Article history: Accepted 28 May 2010 Keywords: Burns Helicopter Transfer Algorithm Referral abstract Introduction: Helicopter emergency medical services play a valuable role in the transfer of critically ill patients. This paper reviews the role of air ambulance services in the provision of regional burns care and suggests guidelines for their use. Methods: A retrospective review of patients treated at the Midlands Adult Burns Centre over a 3-year period. Results: 27 adult burns patients were transported by air ambulance during the study period. Patients were aged 19–89 years (average 41.3 years) with an estimated burn size of 5–70% TBSA. Distance travelled was 11–79 miles (average 41.2 miles). All patients were appropri- ately referred to the burns centre according to national referral guidelines but in 7 cases (26%) it was felt that transport by air ambulance was not clinically indicated and land transfer would have been safe and appropriate. Conclusion: Air ambulances offer a fast and effective means of transferring patients to a regional burns centre in selected cases. There is limited data for the beneficial effects of helicopters and survival benefit is seen only in the most severely injured patients. We suggest criteria for the use of air ambulances in burns patients in order to maximise the benefit and reduce unnecessary flights. # 2010 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author at: 19 Old Oak Rd, Birmingham B38 9AJ, United Kingdom. Tel.: +44 7793359216. E-mail address: elizabeth_chipp@hotmail.com (E. Chipp). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/burns 0305-4179/$36.00 # 2010 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2010.05.023