A helicopter medevac, if available, would have been quicker, presuming patient cooperation and immediate availability of the equipment.
A second call for an ambulance went out about 3 hours after the fall at which point her condition was deteriorating. That ambulance responded within 45 minutes (about the same response time or less than a helicopter called from another locale). Within a few minutes she was at the local hospital which lacked neurosurgical facilities. It took another two and 1/2 hours to get her to the referral center in Montreal.
With a helicopter the last two and 1/2 hour transit time could have been cut in half and the outcome possibly altered, but that is uncertain considering the initial delay and her deteriorating condition.
We shouldn’t be too certain that speed of transfer would be better in the U.S. In Illinois, for example the mean time to transfer emergent cases is a mean of 5 hours 42 minutes as noted below:
“Two-hundred thirty emergent neurosurgical transfers occurred during the study period. The most common diagnoses were parenchymal intracerebral hemorrhage (33%) and subarachnoid hemorrhage (28%). Sixty-six percent of neurosurgical transfers to academic medical facilities originated at hospitals without full-time coverage. The mean time to transfer for all patients was 5 hours 10 minutes (standard deviation, 3 h 42 min; range, 1-20 h 12 min). A decline in Glasgow Coma Scale score was seen in 29 patients. A shortage of neurosurgical intensive care unit beds occurred on 55% of the days in the study. only 19% of emergency cases were related to cranial trauma, and only 3% of transfers came from level 1 trauma”
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