Helicopter emergency medical services response to equestrian accidents

Abstract

Equestrian accidents represent a significant proportion of HEMS missions. The majority of patients injured in equestrian accidents do not require HEMS intervention, however, a small proportion have life-threatening injuries, requiring immediate critical intervention. Further research is warranted, particularly regarding HEMS dispatch, to further improve accuracy of tasking to equestrian accidents.

Utilisation of a Helicopter Emergency Medical Service (HEMS) for equestrian accidents in a regional major trauma network in the United Kingdom

“…Future research is required investigating factors that influence decisions by HEMS teams to transport patients that have suffered injury following equestrian accidents by helicopter and the choice of destination hospital. The workload due to equestrian accidents in our service and the requirement for advanced clinical interventions at scene are comparable to those described in other UK based systems with similar mixed rural and urban populations [4,5]. The results of this study are consistent with those from other UK HEMS units in that a large proportion of HEMS deployments to equestrian accidents were to assist in problems relating to patient access/egress and were associated with high levels of patient conveyance by helicopter and long overall mission timings despite a low frequency of severe injury.…”

“…The challenges faced by both HEMS units and Ambulance Services is how best to balance the need for assistance in cases with challenging access/ egress problems with the requirement to target resources to patients with greatest clinical need. At the present time robust, evidence based tasking criteria that can appropriately and efficiently target deployment of physician-led HEMS resources to cases of severe injury remain elusive and we echo the recommendations of others for further research in this area [5]. Until such criteria have been derived and validated there is a clear requirement for the design and implementation of informed and intelligent tasking models to respond to the need for assistance in equestrian accidents.…”

“…The utilisation of 'Air Ambulances' in response to equestrian accidents has been an integral part of operations for many years throughout the UK [3][4][5], traditionally as a means of providing a transport platform for more expedient transfer from scene to hospital. The potential logistical benefits of utilising aircraft in such cases seem logical, especially in relatively isolated rural areas, enabling more rapid transfer of patients to hospital and releasing land based resources to respond to further emergencies.…”

“…in such cases has, however, been shown to be low [1,2] with very small numbers of patients requiring the provision of pre-hospital critical care interventions such as Rapid Sequence Induction of anaesthesia (RSI) [1,[3][4][5]. The recent establishment of major trauma networks in the UK has placed great emphasis on the appropriate tasking of HEMS units to cases where added benefit can be provided [6].…”