Functional outcome and quality of life of survivors of severe injury have not returned to normal 1 year after trauma. The prevalence of specific limitations in this population is very high (40-70%). Female gender and comorbidity are predictors of long-term disability.

Combined EMS/HEMS assistance at an injury scene is associated with longer OST. When corrected for severity of injury and patient characteristics, no influence of longer OST on mortality could be demonstrated.

The presence of the HMT may increase chances of survival for patients suffering multiple trauma, especially for those with blunt trauma.

Only 5 studies described HEMS dispatch criteria validity. HEMS dispatch based on consciousness criteria seems promising. MOI criteria lack accuracy and will lead to significant overtriage. The first categories needing revision are MOI and age/comorbidity.

In the Netherlands, the costs of HEMS assistance per QALY remain below the acceptance threshold. HEMS should therefore be considered as cost effective.