Annotated Bib 1:

Kim, J., Heo, Y., Lee, J. C., Baek, S., Kim, Y., Moon, J., ... & Jung, K. (2015). Effective transport for

trauma patients under current circumstances in Korea: a single institution analysis of treatment

outcomes for trauma patients transported via the domestic 119 service. Journal of Korean

medical science, 30(3), 336-342. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330491/

This source is an analysis of a 38 month study, from March 2011 to May 2014, conducted

in Korea regarding the transportation of blunt trauma victims either by ground ambulance

(GAMB) or by helicopter emergency services (HEMS). The study also explored differences

between patient demographics, transport time, injury severity score (ISS), and causes of injury.

The results showed that HEMS was an overall more beneficial mode of transportation for blunt

trauma victims compared to GAMB. Out of 1,626 patients who were victims of blunt trauma and

included in the study, 1,547 were transported via GAMB and 79 were transported via HEMS.

The study shows that out of those who were transported with GAMB, 1,400 patients survived,

yielding a survival rate of 90.5%. This is 0.9% lower than the predicted probability of survival

determined by the trauma and injury severity score (TRISS) of the major trauma outcome study

(MTOS), which was 91.4%. The study also reveals that out of those who were transported with

HEMS, 75 survived, giving way to a survival rate of 94.9%. This is 3.5% higher than the MTOS

rate. Though it took longer for people to transported via helicopter (60 minutes) than it did to be

transported by ambulance (47 minutes), both were within the golden hour (the time in which the

patient is most vulnerable; it is crucial to a patient’s chances of survival to receive treatment

within the golden hour). Several factors can explain the difference between the time it took to
transport via helicopter than via ambulance. For example, helicopters are typically used to

transport a victim to a trauma center or hospital from more rural areas, where the nearest hospital

is distant, thus taking a longer time to arrive. Ambulances are generally used in urban areas,

where hospitals and trauma centers are closer. In addition, helicopters take time to take off and

land, which contribute to the time it takes to get from the scene to treatment. The study analysis

also mentions that the HEMS group had a significantly higher proportion of men (78.5% vs.

67.2%), and that 49.0% of trauma victims were involved in motor vehicle accidents. Seven-

hundred sixty-six of those patients were transported via GAMS, while 31 were airlifted. Overall,

the article encourages the integration of HEMS into the Korean trauma transportation system and

to allow a faster administration of prehospital care.

The authors of this article, Jiyoung Kim, Yunjung Heo, John CJ Lee, Sukja Baek,

Younghwan Kim, Jonghwan Moon, Seok Hwa Youn, Heejung Wang, Yo Huh and Kyoungwon

Jung are all qualified to write about the transportation of trauma victims due to their collective

experiences and credentials. As an example, Jiyoung Kim, John CJ Lee, Sukja Baek,

Younghwan Kim, Jonghwan Moon, Seok Hwa Youn, Heejung Wang work in the Department of

Surgery at Ajou University in Suwon, Korea. Yunjung Heo is employed in the Department of

Medical Humanities and Social Medicine at Ajou University in Suwon, Korea, and Yo Huh

works in the Department of Emergency Medicine at Ajou University School of Medicine in

Suwon, Korea. Kyoungwon Jung is the corresponding author. The article lists a telephone

number, fax number, and email at which the authors can be reached. It is all located on a .gov

website- the National Center for Biotechnology Information-, and is in association with the

Journal of Korean Medical Science, thus indicating a government-approved, authoritative article.

Furthermore, the article was published online in 2015, which adheres to the five-year time span
alloted for science articles. The study itself was conducted from 2011-2014. Although it began

outside of the five-year span, it ended within it, and the information acquired from the study is

still relevant. The information from the study was all thoroughly evaluated and addressed, from

interpreting the overarching, basic results (whether HEMS of GAMB was a more effective mode

of transportation), to examining the other aspects of the study, such as what type of accident

occurred most often and by what age group, the costliness and availability of helicopters in

Korea, and the locations from which patients were transported (urban versus rural). The authors

presented a claim and reasoning, and evidence from the study to support their claim. They were

fairly unbiased in their evaluation of the results of the 38-month study (there may be some bias

in an attempt to convince readers to advocate for a larger presence of HEMS) and addressed all

sides of the argument surrounding HEMS and GAMB. For example, though the authors focused

primarily on encouraging the integration of HEMS into their country’s trauma patient care

system, they addressed the fact that people are concerned with the trade-offs of using HEMS

more often, such as their cost and safety. In order to do so, they pulled statistics from the

Emergency Medical Annual Report published by the National Emergency Medical Center. Other

information from the article (besides the information from the study) can be corroborated by

various sources, such as Present Situation of Helicopter Emergency Medical Services (HEMS) in

Korea by C. Lee, J. Cho, H. Yang, J. Kim, W. Park, and G. Lee. There is also a lengthy list of

reference sources at the bottom of the article that one could refer to for corroboration, including

Preliminary study on the establishment of regional trauma center and an operation model in

Korea by Kim Y. and The impact of a rotorcraft aeromedical emergency care service on trauma

mortality by Baxt WG and Moody P. This article was likely intended for scholars and other

educated people as well as authoritative figures. The authors want to convey to the reader that
 the trauma transportation system should be altered to incorporate HEMS and allow for active

initial involvement of medical personnel in an attempt to change the existing system in Korea.

The audience is an appropriate one to receive this message, as scholars will be able to influence

others and possibly perform additional studies, and authoritative figures have the power to

change the system already in place. Overall, this article provides a mostly unbiased evaluation of

the study it surrounds, making it an exceptional article to use in my research.

Annotated Bib 2:
Buchanan, I. M., Coates, A., & Sne, N. (2016, March 16). Does Mode of Transport Confer a

Mortality Benefit in Trauma Patients? Characteristics and Outcomes at an Ontario Lead Trauma
Hospital. Retrieved from https://www.cambridge.org/core/journals/canadian-journal-of-

emergency-medicine/article/does-mode-of-transport-confer-a-mortality-benefit-in-trauma-

patients-characteristics-and-outcomes-at-an-ontario-lead-trauma-

hospital/0050794F837EA4D4BB17891D4E2AF579/core-reader#

This source is an analysis of an 18 year heterogeneous study that took place in Ontario,

Canada surrounding the difference in mortality rate of trauma patients who they were transported

via rotor-wing transport and via ground transport. The study constituted of people who were over

18 with an Injury Severity Score (ISS) of greater than 12, and who were directly transported

from the scene to a Lead Trauma Hospital (LTH). There were a total of 3,146 trauma patients in

the study cohort after they were tested for eligibility. Of the 3,146 victims, 2,759 (87.7%)

patients were transported by ground transportation and 387 (12.3%) were transported by rotor-

wing aircraft. The patients who were transported via helicopter had a lower mortality rate than

those who were transported via ambulance (8.8% vs. 16.1%), though those who were airlifted

were shown to be more severely injured than those who transported by ground. The mortality

rate was lower than expected for helicopter transport and the mortality rate was higher than

predicted for ground transport. Predictions were made using the TRISS-L method, and were

14.7% for ground transport and 14.0 for air transport. In addition, the extrication time (from the

time the call was made to the time the patient’s arrived at LTH) of the ground-transported

patients was significantly shorter than that of the rotor-wing-transported patients; the time for

ground-transported patients was 45 minutes, whereas the time for rotor-wing-transported patients

was 73 minutes. The study also revealed that the most common cause of traumatic injury was

motor vehicle collision and the median age of the test cohort was 47 years old. The authors of the
article ultimately concluded that there were far too many factors to make an accurate claim about

the mortality rates of trauma patients based on their transportation, and that there were additional

studies that would have to be conducted to come to a truly accurate conclusion about what

transportation method was truly superior and what triage of patients should be established to

determine their transportation.

The authors of this article, Ian M. Buchanan, Angela Coates and Niv Sne are all qualified

to evaluate the study regarding the transportation of trauma victims due to their collective

credentials. Ian M. Buchanan works in the Division of Emergency Medicine at McMaster

University in Hamilton, Ontario, Angela Coates is employed in the Trauma Program at Hamilton

General Hospital in Hamilton, Ontario, and Niv Sne is both employed in the Trauma Program at

Hamilton General Hospital in Hamilton, Ontario and in the Department of General Surgery at

McMaster University in Hamilton, Ontario. This analysis was published in September 2016,

thereby following the 5-year timespan alloted for science articles and making this one current on

the topic of emergency transportation systems. The authors thoroughly evaluated the data and

covered both broad and deep aspects of the topic; they first addressed the fundamental results

and then delved into the more specific outcomes of the study. The article was completely

unbiased, and addressed all sides of the argument. For example, the authors concluded that,

though helicopters resulted in a decreased mortality rate despite a higher level of injury, there

were many other aspects of the study that needed further experimentation on in order to come to

a proper conclusion on the matter. They also thoroughly explained why some of the results that

appeared in the study occurred. Nonetheless, the information was accurate, as can be

corroborated by many sources. According to the article, trauma is the main cause of death in

individuals under the age of 44 in North America, and that unintentional injury is the fifth
leading cause of death in all ages and from people all over the world. That information can be

corroborated by sources that the author cite in their references list, such as the World Health

Organization, making the information in the article accurate. The first statistic mentioned above

cannot be corroborated by the source listed in the authors’ citation, as the website cannot be

accessed. This lessens the accuracy of the article, though not by much, as the statistic can be

found on the Centers for Disease Control and Prevention (CDC) website. The purpose of this

article is to inform highly-educated people about the use of different transportation methods for

trauma victims. The audience is implied with the use of advanced vocabulary and specialized

terms used in emergency medicine. The article is appropriate for the audience because it will

inform highly-educated people about the effectiveness of the transportation system in Ontario

and may lead them to conduct a study on their own. Overall, this article thoroughly analyzed the

study in an unbiased fashion. Though authors did not come to an absolute conclusion, the study

itself yielded results that will be extremely beneficial to my research.