The Impact of Helicopter Emergency Medical Service Night Operations in South East England

Curtis, Leigh; Salmon, Mark; Lyon, Richard

doi:10.1016/j.amj.2017.06.005

Cited by 10 publications

(15 citation statements)

References 7 publications

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“…In our study, on average 20% of missions were not flown due to poor weather conditions, and during winter time the percentage of missions not flown was up to 40%. Previous studies in areas with similar seasons have reported parallel findings [1, 2, 4]. A Norwegian study of three HEMS bases reported that the proportion of missions that were denied or cancelled due to poor weather conditions increased from 5.1 to 8.4% during the winter months, making it 1.6 times greater than the annual average of missions denied or cancelled due to weather conditions [2].…”

Section: Discussionmentioning

confidence: 66%

“…Poor weather conditions have been reported to frequently cause denied or cancelled HEMS and search and rescue (SAR) missions [1–4, 17]. Studies have reported that 5.1–9.7% of all requested HEMS missions are denied or cancelled yearly due to poor weather conditions with the rotor wing aircraft [1, 2].…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown that air medical transport improves survival of many patients with medical and trauma emergencies [1], yet overall more than one third of all helicopter emergency medical service (HEMS) missions are denied or cancelled [1–3]. A significant percentage of denied or cancelled HEMS missions is caused by poor weather conditions [1, 3, 4]. Nevertheless, the role of icing weather conditions is unknown within denied or cancelled HEMS missions.…”

Section: Introductionmentioning

confidence: 99%

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Impact of icing weather conditions on the patients in helicopter emergency medical service: a prospective study from Northern Finland

Pulkkinen¹,

Pirnes²,

Rissanen³

et al. 2019

Scand J Trauma Resusc Emerg Med

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BackgroundA high number of denied or cancelled HEMS missions are caused by poor weather conditions especially during winter season. Furthermore, many helicopter manufacturers have denied their helicopters to be operated in known icing conditions. Icing is a widely known phenomenon in aviation, but there is a lack of evidence about its influence on HEMS operations and patients.MethodsA prospective observational study of HEMS missions in Northern Finland was conducted over a 1-year period in 2017. A patient was included in the study when the use of helicopter was denied or cancelled due to icing weather conditions. Patients were categorised into two groups based on whether definitive treatment was delayed or not according to previously defined end-points.ResultsDuring the study period the Finnish northernmost HEMS unit received 1940 missions. A total of 391 missions (20%) could not be operated by helicopter because of poor weather conditions. In 142 of these missions (36%) icing was one of the limiting weather factors. The year-round incidence of icing was 7.3/100 missions. A total of 57 patients were included in the analysis. Icing weather conditions, resulting in denied helicopter flights, caused a delay in definitive treatment for 21 patients (37%). Definitive treatment was more often delayed in trauma and internal medicine patients than in neurological patients. Nevertheless, the patients whose definitive treatment was delayed were located closer to the hospital. The estimated time that would have been saved by helicopter transport was more than 60 min for 10 patients with delayed treatment.ConclusionsIn this study the incidence of icing weather conditions was substantial compared to all HEMS missions in year 2017. The delay in definitive treatment was accentuated among trauma and internal medicine patients. During the 1-year study period many patients whose definitive treatment was delayed would have had a notable (> 60 min) time saved by helicopter transport. A helicopter equipped with an adequate ice protection system for the weather conditions in Northern Finland would have shortened the delay in patients’ definitive treatment significantly.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of icing weather conditions on the patients in helicopter emergency medical service: a prospective study from Northern Finland

Pulkkinen¹,

Pirnes²,

Rissanen³

et al. 2019

Scand J Trauma Resusc Emerg Med

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“…In our trauma system, with a robust ambulance critical care service, we hypothesize that time savings could be made during night HEMS missions in which the aircraft is met by a land ambulance, either at an ad hoc or presurveyed landing site. 20 Our study has several limitations. First, the generalizability of our findings is limited.…”

Section: Discussionmentioning

confidence: 91%

Feasibility of Prehospital Rapid Sequence Intubation in the Cabin of an AW169 Helicopter

McHenry¹,

Curtis²,

Avest

et al. 2020

Air Medical Journal

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Prehospital rapid sequence intubation (RSI) is an important aspect of prehospital care for helicopter emergency medical services (HEMS). This study examines the feasibility of in-aircraft (aircraft on the ground) RSI in different simulated settings. Methods: Using an AW169 aircraft cabin simulator at Air Ambulance Kent Surrey Sussex, 3 clinical scenarios were devised. All required RSI in a "can intubate, can ventilate" (easy variant) and a "can't intubate, can't ventilate" scenario (difficult variant). Doctor-paramedic HEMS teams were video recorded, and elapsed times for prespecified end points were analyzed. Results: Endotracheal intubation (ETI) was achieved fastest outside the simulator for the easy variant (median = 231 seconds, interquartile range = 28 seconds). Time to ETI was not significantly longer for in-aircraft RSI compared with RSI outside the aircraft, both in the easy (p = .14) and difficult variant (p = .50). Wearing helmets with noise distraction did not impact the time to intubation when compared with standard inaircraft RSI, both in the easy (p = .28) and difficult variant (p = .24). Conclusion: In-aircraft, on-the-ground RSI had no significant impact on the time to successful completion of ETI. Future studies should prospectively examine in-cabin RSI and explore the possibilities of in-flight RSI in civilian HEMS services.

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“…This study was used to motivate the need for a night time air ambulance service in KSS. Curtis et al (2017) followed up on this work by looking at the implementation of an emergency medical night time service in KSS over a two year period. This paper sought to compare the actual need for the HEMS night time service to the previously estimated need.…”

Section: Background and Literaturementioning

confidence: 99%

Strategic Decision Making for the North West Air Ambulance Charity using Discrete Event Simulation

L¹,

Brooks²

2020

Proceedings of SW20 the OR Society Simulation Workshop

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This paper is a preliminary investigation of the provision of enhanced emergency health care at night by North West Air Ambulance (NWAA). A discrete event simulation model of the current NWAA operational system is presented. This model is used to investigate the provision of NWAA services by an air ambulance vs. a rapid response vehicle. More widely, this model will be used within the scope of investigating what NWAA describe to be their 'optimal service hours'.

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The Impact of Helicopter Emergency Medical Service Night Operations in South East England

Cited by 10 publications

References 7 publications

Impact of icing weather conditions on the patients in helicopter emergency medical service: a prospective study from Northern Finland

Impact of icing weather conditions on the patients in helicopter emergency medical service: a prospective study from Northern Finland

Feasibility of Prehospital Rapid Sequence Intubation in the Cabin of an AW169 Helicopter

Strategic Decision Making for the North West Air Ambulance Charity using Discrete Event Simulation

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