Challenges of helicopter mountain rescue missions by human external cargo: need for physicians onsite and comprehensive training

Pietsch, Urs; Strapazzon, Giacomo; Ambühl, Dimitri; Lischke, V.; Rauch, Simon; Knapp, Jürgen

doi:10.1186/s13049-019-0598-2

Cited by 25 publications

(19 citation statements)

References 22 publications

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“…The most common medical intervention on site was anesthesia or analgesia, in 17% (n = 142) fentanyl or ketamine were used. Since medical interventions must be performed in difficult terrain, with limited human resources and limited surveillance, research findings indicate that doctors, who have clinical experience in these procedures and are specially and systematically trained in HEC technology, need to be present at the scene (Pietsch, Strapazzon, Ambühl, Lischke, Rauch, and Knapp, 2017). M. Pasquier, L. Marxer, H. Duplain and co-authors conducted research based on helicopter rescue missions to mountain huts in the Swiss Alps.…”

Section: Scientific Research In the Field Of Air Rescuementioning

confidence: 99%

Mountain Rescue in Non-Profit Organizations: Interdisciplinary Research Spectrum in Mountain Tourism

Nagody-Mrozowicz¹,

Halemba²

2021

ERSJ

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Purpose: The purpose of the presented article is to fill the existing epistemological gap in the analyzed phenomenon, which will be filled with aspects of mountain rescue in non-profit organizations. In connection with the above, certain issues may meet with the interest of the world of science, which will expand the research horizons and theoretical perspectives of the analyzed social processes. In addition, the article may become a contribution to the increase in the publishing activity and development of a bibliographic base, that is a literary source of scientific knowledge in the field of activities of non-profit mountain rescue organizations. This article is the first study that is a synthesis of scientific achievements in the field of professional mountain rescue. It is a compilation of the most important research results published so far in the field of saving people in the mountains. Design/Methodology/Approach: The research used a theoretical analysis focused on the presentation of source literature and a literature review showing the directions, areas and research issues in the studied thematic area, mountain rescue. Findings: Mountain rescue is an interdisciplinary phenomenon and process that includes knowledge and skills in many fields and scientific disciplines. Among the sciences that significantly affect the practical functioning of mountain rescue, the following can be identified: medical sciences, health sciences, technical and engineering sciences as well as social sciences. Practical Implications: The further development of research on the presented aspects of mountain rescue leads to the improvement of rescue strategies and techniques used in them. Knowledge of the presented research areas allows scientists to constantly deepen their research and theory in this field: technology for rescue and transport, life functions of the human body in mountain accident conditions and human behavior during mountain activity. Originality/value: The activities of mountain rescue organizations include various forms of conducting rescue operations, which include the following aspects: medical and therapeutic, logistics and transport, meteorological, technological, psychosocial and, last but not least, competence and training.

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Section: Scientific Research In the Field Of Air Rescuementioning

confidence: 99%

Mountain Rescue in Non-Profit Organizations: Interdisciplinary Research Spectrum in Mountain Tourism

Nagody-Mrozowicz¹,

Halemba²

2021

ERSJ

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“…There are some studies analysing prehospital times in alpine HEMS (5,15,16). Several factors are discussed, which potentially contribute to longer time intervals for alpine rescue compared to urban or suburban rescue missions.…”

Section: Need For Hems Crews With Advanced Skillsmentioning

confidence: 99%

“…The topic of HHO in HEMS missions is very rarely addressed in the scienti c medical literature (3)(4)(5). We do know, however, that nighttime imposes, due to reduced visible cues, an additional, but manageable, risk for HEMS operations.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Challenges of Helicopter Emergency Medical Service (HEMS) Rescue Missions with Helicopter Hoist Operations: Analysis of 12,000 Daytime and Nighttime Missions in Switzerland

Pietsch

Knapp

Mann³

et al. 2021

Preprint

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ObjectiveWe aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions.MethodsWe designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) from 1 January 2010 to 31 December 2019.ResultsDuring the study period, 9,963 (88.7%) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3%) at night. Of the victims with time-critical injuries (NACA ≥4), 21.1% (n=400) reached the hospital within 60 min during the day, and 9.1% (n=18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score ≥4were independently and highly significantly associated with longer mission times (p<0.001). The greatest proportion of patients, who needed hoist or HEC operations in the course of the HEMS mission during daytime, sustained moderate injuries (NACA 3, n=3,731, 37.5%) while practicing recreational activities (n=5,492, 55.1%). In daytime HHO missions, the most common medical interventions performed were an insertion of a peripheral intravenous access (n=3,857, 38.7%) and administration of analgesia (n=3,121, 31.3%). ConclusionsNearly 20% of patients, who needed to be evacuated by a hoist, were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.

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“…Pre-hospital search and rescue (SAR) missions commonly feature prolonged times and patients often have critically impaired vital functions. (8)(9)(10) Hypotension in multi-trauma patients with TBI in remote and mountainous areas could therefore be even more common than in urban areas.…”

Section: Introductionmentioning

confidence: 99%

Severe traumatic brain injury and hypotension is a frequent and lethal combination in mountain trauma patients – an analysis of the International Alpine Trauma Registry

Rauch¹,

Marzolo²,

Cappello³

et al. 2020

Preprint

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Background: Hypotension is associated with worse outcome in patients with traumatic brain injury (TBI) and maintaining a systolic blood pressure (SBP) ≥110 mmHg is recommended. The aim of this study was to assess the incidence of TBI in patients suffering multi-trauma in remote and mountainous areas; to describe associated factors, treatment and outcome compared to non-hypotensive patients with TBI and patients without TBI; and to evaluate pre-hospital variables to predict admission hypotension.Methods: Data from the International Alpine Trauma Registry including mountain multi-trauma patients (ISS≥16) collected between 2010 and 2019 were analysed. Patients were divided into three groups: 1) TBI with hypotension, 2) TBI without hypotension and 3) no TBI. TBI was defined as Abbreviated Injury Scale (AIS) of the head/neck ≥3 and hypotension as SBP <110 mmHg on hospital arrival.Results: A total of 287 patients were included. Fifty (17%) had TBI and hypotension, 92 (32%) suffered TBI without hypotension and 145 (51%) patients did not have TBI. Patients in group 1 were more severely injured (mean ISS 43.1±17.4 vs 33.3±15.3 vs 26.2±18.1 for group 1 vs 2 vs 3, respectively, p<0.001). Mean SBP on hospital arrival was 83.1±12.9 vs 132.5±19.4 vs 119.4±25.8 mmHg (p<0.001) despite patients in group 1 received more fluids. Patients in group 1 had higher INR, lower haemoglobin and lower base excess (p<0.001). The rate of hypothermia on hospital arrival was different between the groups (p=0.029). Patients in group 1 had the highest mortality (24% vs 10% vs 1%, p<0.001).Conclusion: Multi-trauma in the mountains goes along with severe TBI in almost 50%. One third of patients with TBI is hypotensive on hospital arrival and this is associated with a worse outcome. No single variable or set of variables easily obtainable at scene was able to predict admission hypotension in TBI patients.

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Challenges of helicopter mountain rescue missions by human external cargo: need for physicians onsite and comprehensive training

Cited by 25 publications

References 22 publications

Mountain Rescue in Non-Profit Organizations: Interdisciplinary Research Spectrum in Mountain Tourism

Mountain Rescue in Non-Profit Organizations: Interdisciplinary Research Spectrum in Mountain Tourism

Incidence and Challenges of Helicopter Emergency Medical Service (HEMS) Rescue Missions with Helicopter Hoist Operations: Analysis of 12,000 Daytime and Nighttime Missions in Switzerland

Severe traumatic brain injury and hypotension is a frequent and lethal combination in mountain trauma patients – an analysis of the International Alpine Trauma Registry

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