The mission characteristics of a newly implemented rural helicopter emergency medical service

Abstract

BackgroundPhysician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care. This paper describes the integration of such a system in a rural Swedish county.MethodsThis is a retrospective database study recording the outcomes of every emergency call centre dispatch request as well as the clinical and operational data from all completed missions during this service’s first year in operation.ResultsDuring the study period, HEMS completed 478 missions out of which 405 (84,7%) were primary missions to prehospital settings and 73 (15,3%) were inter-hospital critical care transfers. A majority (55,3%) of primary missions occurred in the regions furthest from our hospitals, in municipalities housing only 15,6% of the county’s population. The NACA (IQR) score on primary and secondary missions was 4 (2) and 5 (1), respectively.ConclusionsThis study describes the successful integration of a physician-based air ambulance service in a Scandinavian rural region. Municipalities distant from our hospitals benefitted as they now have access to early specialist intervention and expedient transport to critical hospital care. Our hospitals and most populated areas benefitted from HEMS secondary mission capability as they gained a dedicated ICU transport service that could provide specialist intensive care during rapid inter-hospital transfer.

The first seven years of nationally organized helicopter emergency medical services in Finland – the data from quality registry

“…In the future electronic transfer of measurements could be used to reduce typing errors, however, this does not eliminate the errors in measurement per se. The rate of cancelled or denied missions in the Finnish HEMS system is substantially higher than reported elsewhere [6,7,21,22]. Technical reliability of the service seems to be excellent and it contributed to the cancellation rate minimally.…”

“…Key findings of this study were that in the Finnish HEMS system a large proportion of missions are cancelled or denied, and a relatively small percentage of patients are transported by helicopter. We also found that the medical problem for HEMS dispatch differ from comparable systems [7,8,21].…”

“…Quality registries are a valuable source of data when evaluating the performance of any field in health care [4,5]. For this purpose, several HEMS systems utilize databases to collect and analyze mission data [6][7][8]. To enable multi-center research and comparison between systems, guidelines for data collection have been published for prehospital airway management [9,10]., cardiac arrest [11,12].…”

What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature

“…The search strategy led to the inclusion of 38 articles describing 20 HEMS models from 12 different countries. Five model descriptions included specific mention of a joint HEMS and inter-facility care function: Australia (New South Wales) [2]; Australia (Victoria) [3]; Eastern Denmark [4]; Norway [5]; Sweden (Dalarna) [6]. The remaining 15 models described a HEMS function only.…”

Missions of the Helicopter Emergency Medical Service in rural and urban areas in Poland – A comparative retrospective analysis

“…The study conducted by Kottmann et al in Switzerland concerning HEMS missions to patients with body injuries showed that the clinical status of the patients was mild and moderate (NACA 1-3) [23]. Studies by Kornhall et al concerning HEMS missions in rural areas in Sweden and HEMS missions in Norway conducted by Østerås et al, revealed that the average NACA score was 4 [22,29]. In the study conducted by Newgard et al lower GCS, lower systolic blood pressure, abnormal number of breaths and pulse, were observed more often in patients treated in urban areas [26].…”