CCT CORE mission
- Assembled in 2008 with support from MedEvac Foundation International and Dr. Suzanne K. Wedel of Boston MedFlight, CCT CORE aims to facilitate collaboration in transport medicine research.
- We are interested in all modes of specialized patient transport, with particular focus on air medical triage, utilization, and potential benefits.
- CCT CORE is managed by faculty and fellows of the EMS Division at Beth Israel Deaconess Medical Center & Harvard Medical School.
HEMS Outcomes Assessment Research Database: HOARD
- HOARD is a spreadsheet assembly of HEMS research addressing patient-centered outcomes.
- While not comprehensive, HOARD may be a useful information source for those interested in HEMS potential benefits on patient outcomes.
- HOARD is described in detail in a 2023 Air Medical Journal paper and in follow-up updates (all are referenced in the bibliography on this website).
- HOARD can be downloaded from the link at the top of this website and questions should be directed to Stephen H. Thomas: shthoma1@BIDMC.Harvard.edu.
HEMS monograph
- There are myriad questions surrounding HEMS triage, logistics, utilization, and potential benefits. CCT CORE offers a monograph introduction for those interested in exploring the state of evidence on these issues.
- The monograph can be downloaded from the link at the top of this page and questions should be directed to Stephen H. Thomas: shthoma1@BIDMC.Harvard.edu.
The CCT CORE ASSIST Project
Air/Ground Selection Support for Interfacility & Scene Triage:
The CCT CORE ASSIST Project
- ASSIST aims to synthesize existing evidence and vehicle triage guidelines into a practical tool. We hope to encompass scene (primary) and interfacility (secondary) missions for all diagnoses by examining development of a dynamic triage tool that goes beyond static variables and incorporates real-time variables such as logistics.
- ASSIST plans entail gathering of national vehicle triage guidelines and synthesis of those guidelines into a freely available set of recommendations (e.g. flowcharts).
- IT is hoped that ASSIST may evolve to use artificial intelligence to inform triage decisions by rapid accessing of information such as mapping and traffic conditions. The idea for ASSIST is to allow regions to "program" their own preferences into the triage tool.
- ASSIST's ultimate goal is to provide prehospital regions with capability to generate regional-consensus triage plans and render these plans practical for situational application.
Other ongoing investigations
- CCT CORE's current interests include evaluation of clinical and time-based logistics circumstances in which helicopter transport may be advantageous.
- CCT CORE is interested in any study that can add to the evidence basis for transport mode decisions.
- In addition to ASSIST (described above), other projects include evaluation of trauma outcomes, time-savings as a surrogate endpoint, and the effects that local logitics (e.g. on-site or off-site helipad) can have on HEMS potential utility.
Stabilizing Patients Rapidly for Interfacility Transport: SPRINT
- To aid in streamlining HEMS crew stabilization time at referring hospitals, CCT CORE authored SPRINT: Stabilizing Patients Rapidly for INterfacility Transport.
- SPRINT was developed with support from MedEvac Foundation International and the Oklahoma State Department of Health. SPRINT materials are freely available via emailing CCT CORE (click below).
CCT CORE bibliography
Commencing with the initial CCT CORE project, a 10-center North American airway study, CCT CORE collaborators have worked to contribute to the transport evidence base. A partial bibliography follows.
Airway
Thomas S, Judge T, Lowell MJ, MacDonald RD, Madden J, Pickett K, Werman HA, Shear ML, Patel P, Starr G, Chesney M, Domeier R, Frantz P, Funk D, Greenberg RD. Airway management success and hypoxemia rates in air and ground critical care transport: A prospective multicenter study. Prehospital Emergency Care 2010; 14:283-291.
Price B, Arthur AO, Brunko M, Frantz P, Dickson JO, Judge T, Thomas SH. Hemodynamic consequences of ketamine vs etomidate for endotracheal intubation in the air medical setting. American Journal of Emergency Medicine 2013; 31:1124-1132.
Artificial intelligence in HEMS
Hsueh J, Fritz C, Thomas CE, Reimer AP, Reisner AT, Schoenfeld D, Haimovich A, Thomas SH. Applications of artificial intelligence in helicopter EMS: a scoping review. Air Med J 2023, published online 20 Dec 2023. doi 10.1016/j.amj.2023.11.012
Antibiotics for open fractures
Thomas SH, Arthur AO, Howard Z, Shear ML, Kadzielski JJ, Vrahas MS. Helicopter EMS crew administration of antibiotics for open fractures: TREAT Fx Study. Air Medical Journal 2013; 32(2):74-79.
HEMS literature overview & broad-based outcomes studies
Rudman JS, Fritz CL, Thomas SA, McCartin M, Price J, Blumen IJ, Thomas SH. Helicopter EMS outcomes research 1983 to 2022: Evidence overview and longitudinal trends. Air Med J 2023. doi 10.1016/j.amj.2023.07.003
Schoenfeld D, Thomas CE, McCartin M, Blumen IJ, Galvagno SM, Thomas SH. Natural experiment outcomes studies in rotor-wing air medical transport: Systematic review and meta-analysis of before-and-after and helicopter-unavailable publications 1970-2022. Air Med J 2023. doi 10.1016/j.amj.2023.11.005
Fritz CL, Rudman J, McCartin M, Price J, Shecter J, Backstrom D, Thomas SA, Thomas SH. Recent outcomes research in helicopter EMS: A scoping review of publication-year 2023 additions to the Helicopter Outcomes Assessment Research Database. Air Med J 2024. doi 10.1016/j.amj.2024.05.002
Fritz CL, Thomas CE, Skaggs M, Zernicke L, McCartin MP, Blumen IJ, Price J, Hibberd O, Schoenfeld D, Thomas SH. Recent outcomes literature in Helicopter EMS: A scoping review of the publication-year 2024 additions to the Helicopter Outcomes Assessment Research Database. Air Med J 2025. doi 10.1016/j.amj.2025.04.005
Patient safety
MacDonald R, Yelle R, Oake-Vecchiato J, Melis C, Bigham BL. Derivation of a taxonomy to categorize adverse events and near-misses in transport medicine. Air Medical Journal 2011; 30(5): 254-255.
GIS systems in HEMS logistics
Soulek JJ, Arthur AO, Williams E, Schieche C, Banister N, Thomas SH. Geographical information systems (GIS) programs' accuracy for interfacility air transport distances and times. Air Medical Journal 2014; 33: 165-171.
Time savings & related outcomes benefit
Phillips M, Arthur AO, Chandwaney R, Hatfield J, Brown B, Pogue K, Thomas M, Lawrence M, McCarroll M, McDavid M, Thomas SH. Helicopter transport effectiveness of patients for primary percutaneous coronary intervention. Air Medical Journal 2013; 32: 144-152.
Pathan S, Soulek J, Qureshi I, Werman H, Reimer A, Brunko MW, Alinier G, Irfan FB, Thomas SH. Helicopter EMS and rapid transport for ST-elevation myocardial infarction: The HEARTS Study. J Emerg Med Trauma Acute Care 2017; 8.
Price J, Rudman J, Schoenfeld D, Thomas SA, Rees P, Bloom B, McCartin M, Blumen I, Thomas SH. Survivorship with incrementally faster times to primary percutaneous coronary intervention (SWIFT-PPCI): A systematic review and meta-analysis. Am J Cardiol 2023; 207: 356-362. doi 10.1016/j.amjcard.2023.08.178
Schoenfeld D, Ho KKL, McCartin MP, Fritz C, Petcu R, Cohen J, Ottanelli C, Ullman E, Blumen I, Thomas SH. Longitudinal assessment of a single referring-receiving hospital pair to assess air vs. ground elapsed time from transport request to arrival at cardiac catheterization laboratory: An observational cohort study. Air Med J 2024 (available online 9 Dec 2024); doi 10.1016/j.amj.2024.11.007
Legere B, Mohamed A, Elsherifc S, Saqqurd R, Schoenfeld D, Slebonick AM, McCartin M, Price J, Zachrison KS, Edlow JA, Saqqur M, Shuaib S, Thomas SH. Success with incrementally faster times to endovascular therapy (SWIFT-EVT): A systematic review and meta-analysis. J Stroke Cerebrovasc Dis 2024; 10.1016/j.jstrokecerebrovasdis.2024.107964
Trauma, hemorrhage control, & transfusion
Fritz C, Thomas SA, Galvagno SM, Thomas SH. Survival benefit of helicopter scene response for patients with an injury severity score of at least nine: A systematic review and meta-analysis. Prehosp Emerg Care 2023 ePub Jul18 doi 10.1080/10903127.2023.2232453
Schoenfeld D, Rosen C, Harris TE, Thomas SH. Assessing the one-month mortality impact of civilian-setting prehospital transfusion: A systematic review and meta-analysis. Acad Emerg Med 2024 ePub Mar22 doi 10.1111/acem.14882
McCartin MP, Wool GD, Thomas SA, Panfil M, Schoenfeld D, Blumen IJ, Tataris KL, Thomas SH. Management considerations for air medical transport programs transfusing RhD positive red-blood-cell containing products to females of childbearing potential. Air Med Journal 2024; doi 10.1016/j.amj.2024.03.012