Evidence map›Paper›PMID 41233838›Full record

ArticleScandinavian journal of trauma, resuscitation and emergency medicine2025

Barriers to helicopter emergency medical services in a Haze-Prone, mountainous region of Northern Thailand.

Krongkarn Sutham, Prasan Piamanan, Boonyarit Kamthip, Weerapont Kaewpaengchan, Nattikarn Meelarp, Wachira Wongtanasarasin, Borwon Wittayachamnankul

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In one paragraph

Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Krongkarn SuthamDepartment of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Prasan PiamananDepartment of Emergency Medicine, Nakornping Hospital, Chiang Mai University, Chiang Mai, Thailand.
Boonyarit KamthipDepartment of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Weerapont KaewpaengchanSriphat Medical Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Nattikarn MeelarpDepartment of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Wachira WongtanasarasinDepartment of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Borwon WittayachamnankulDepartment of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. borwon.witt@cmu.ac.th.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectiveTo identify factors associated with the mission outcome (transport completed vs. not transported) of air medical transport (AMT), with particular attention to environmental and operational constraints such as haze-related air pollution.

methodsWe conducted a retrospective analysis of all requests to the Northern Thailand Sky Doctor program (SkyDoc) from Jan 1, 2020, to Sept 30, 2024. Patient demographics, mission characteristics, environmental conditions, and operational variables were extracted from program records and merged with daily PM2.5 and PM10 concentrations from the national air quality monitoring network. The primary outcome was mission outcome, defined as transport completed versus not transported. We analyzed factors associated with non-transport.

resultsAmong 656 mission requests, 412 (62.8%) were transport and 244 (37.2%) were not transported. Patients were predominantly male (57.2%) with a median age of 49 years (IQR 28-67). The most frequent diagnostic categories were ST-elevation myocardial infarction (32.3%), major trauma (21.2%), and stroke (11.7%). Non-transport was most often due to medical contraindications (25.8%), aircraft or landing-zone unavailability (23.8%), adverse weather (18.9%), and haze-related air pollution (12.7%). Seasonal peaks in not transport were observed from February through April, coinciding with regional surges in particulate matter. In multivariable analysis, twilight-hour requests (16:00-20:00) were associated with non-transport (adjusted OR 0.29; 95% CI 0.13-0.67; p < 0.01), whereas secondary missions were more likely to be transport than primary missions (adjusted OR 3.51; 1.47-8.40; p < 0.01). Higher PM2.5 concentrations were independently associated with non-transport (adjusted OR 0.99; 0.97-0.99; p = 0.018). PM10 was not associated with outcomes.

conclusionAMT in northern Thailand is constrained by both medical and environmental factors. Twilight-hour requests, mission type, and PM2.5 concentrations independently influenced mission completion. These findings highlight the need for haze-adapted flight protocols, enhanced forecasting, and system-level strategies to safeguard patient access to aeromedical care during seasonal pollution surges.

Indexed as

Air AmbulancesAir PollutionEmergency Medical ServicesAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesThailandAir ambulancesAir pollutionEmergency medical servicesHelicoptersSoutheast asia

Identifiers

PMID41233838
PMCPMC12613902

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.