Profiling helicopter emergency medical service winch operations involving physicians in Queensland, Australia

Abstract

Objective: To analyse the mission profiles of helicopter emergency medical service (HEMS) winch operations involving LifeFlight Retrieval Medicine physicians in Queensland, Australia, specifically focusing on patients' clinical characteristics, extrication methods and scene times. Methods: A retrospective analysis was performed to identify all helicopter winch missions involving physicians during 2019. Demographic, clinical and non-clinical data were accessed from an electronic database used to log cases and findings presented using descriptive statistics. Results: Out of 4356 HEMS missions involving physicians, 100 (2.3%) were winch operations. Of these, 31 (31%) occurred overwater and 12 (12%) at night. In total, 106 patients were attended, and eight patient deaths occurred. Most patients were traumatically injured (66%), male (66%) and had a median (interquartile range) age of 43.5 (28-59) years. Thirteen missions (13%) involved drowning victims. This group had a higher burden of injury and comprised half of the patients treated with endotracheal intubation. Median scene time was 30 min (20-40), and the winch stretcher was the predominant patient extrication method. Physician winching occurred in 63 (63%) missions and was associated with increased scene time and increased use of the winch stretcher. Conclusions: Winch operations involving physicians occur infrequently in Queensland HEMS, although almost a third of missions occur overwater. Drowning victims are encountered more frequently than reported elsewhere in Australian HEMS and comprised half of the patients who underwent endotracheal intubation. Patients' severity of illness and injury may contribute to the associations between winching of physicians, increased scene times and increased use of the winch stretcher.

Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016 to 2021: a nationwide registry-based study with 30-day follow-up

“…The available literature on a nationwide population of drowning patients treated by a physician-staffed HEMS is scarce. The available body of evidence focusing on physician-staffed HEMS mainly constitutes data on traumatic injuries, paediatric emergencies, cardiac arrests, or winch operations [7,[22][23][24][25][26].…”

“…There was no significant difference in total mission or response time between fatal and non-fatal drowning missions. The Danish Air Ambulance spent significantly more time providing medical care onscene in the group with a fatal outcome (median [IQR] 28 [21][22][23][24][25][26][27][28][29][30][31][32] minutes vs. 19 [16][17][18][19][20][21][22][23][24][25][26][27][28][29] minutes, p = 0.01). Most drowning missions treated by the Danish Air Ambulance occurred during the Danish summer months and public holidays of June-August (52%).…”

A comparative study on specialized services in pre-hospital emergencies in Iran and selected countries

“…Specialized services : The use of helicopter emergency medical service (HEMS) to provide special services to drowned patients is one of the measures taken in recent years. [ 47 ] Since Australia is an accident-prone country, addressing major traumas in the pre-hospital system has increased by ten times compared to in-hospital accidents in recent years. [ 48 ] Australia, with its unique geographical conditions and being surrounded by oceans, has put natural disaster response as the priority of all emergency measures.…”