Primary scene responses by Helicopter Emergency Medical Services in New South Wales Australia 2008–2009

Abstract

BackgroundDespite numerous studies evaluating the benefits of Helicopter Emergency Medical Services (HEMS) in primary scene responses, little information exists on the scope of HEMS activities in Australia. We describe HEMS primary scene responses with respect to the time taken, the distances travelled relative to the closest designated trauma hospital and the receiving hospital; as well as the clinical characteristics of patients attended.MethodsClinical service data were retrospectively obtained from three HEMS in New South Wales between July 2008 and June 2009. All available primary scene response data were extracted and examined. Geographic Information System (GIS) based network analysis was used to estimate hypothetical ground transport distances from the locality of each primary scene response to firstly the closest designated trauma hospital and secondly the receiving hospital. Predictors of bypassing the closest designated trauma hospital were analysed using logistic regression.ResultsAnalyses included 596 primary missions. Overall the HEMS had a median return trip time of 94min including a median of 9min for activation, 34min travelling to the scene, 30min on-scene and 25min transporting patients to the receiving hospital. 72% of missions were within 100km of the receiving hospital and 87% of missions were in areas classified as ‘major cities’ or ‘inner regional’. The majority of incidents attended by HEMS were trauma-related, with road trauma the predominant cause (44%). The majority of trauma patients (81%) had normal physiology at HEMS arrival (RTS = 7.84). We found 62% of missions bypassed the closest designated trauma hospital. Multivariate predictors of bypass included: age; presence of spinal or burns trauma; the level of the closest designated trauma hospital; the transporting HEMS.ConclusionOur results document the large distances travelled by HEMS in NSW, especially in rural areas. The high proportion of HEMS missions that bypass the closest designated trauma hospital is a seldom mentioned benefit of HEMS transport. These results along with the characteristics of patients attended and the time HEMS take to complete primary scene responses are useful in understanding the benefit HEMS provides and the services it replaces.

Factors influencing on-scene time in a rural Norwegian helicopter emergency medical service: a retrospective observational study

“…Reported factors affecting the OST in all missions by a service are of little interest due to the large variation between different patient groups. The HEMSs in the US, Canada, Australia, and Europe differ greatly in crew composition, service hours, mission types, patient conditions, and on-scene strategy; therefore, different OSTs are reported (8 to 40 min) [ 9 , 21 , 28 , 30 , 41 , 42 ]. Comparisons to such heterogeneous studies are challenging.…”

A descriptive study of trauma patients transported by helicopter emergency medical services to a level one trauma centre

“… [10] where males accounted for 62% of all the patients that were transported, and Taylor et al. [11] in Australia noted similar findings. Wong et al.…”

Deslocamento Espacial E Tempo De Transferência Primária Dos Pacientes Traumatizados Nas Rodovias Do Estado Do Paraná, Brasil

“…No presente estudo, o tempo médio para T1 foi de 23 ± 12 minutos, T2 de 31 ± 16 minutos e T3 de 18 ± 9 minutos, totalizando um tempo total de atendimento em média de 1 hora e 13 minutos ± 24 minutos (Figura 2). Apesar de não ter sido encontrado uma literatura descrevendo o tempo padrão para cada intervalo de tempo, um estudo realizado na Austrália descreve um tempo de deslocamento de 34 min, tempo de cena de 30 e transporte para hospital de 25 minutos (TAYLOR, et al, 2012). O tempo de cena foi o período em que se demandou maior parcela do tempo total de atendimento (Figura 3B), concordando com os achados de Taylor et al (2012), e podem estar relacionados ao mecanismo de trauma, necessidade de retirada das vítimas das ferragens ou intervenções avançadas na cena de trauma (intubação orotraqueal, controle de hemorragia) (KLEIN, 2019;WHEY et al,2013).…”