Helicopter‐based emergency medical services for a sparsely populated region: A study of 42,500 dispatches

Abstract

BackgroundThe Helicopter Emergency Medical Service (HEMS) in Norway is operated day and night, despite challenging geography and weather. In Western Norway, three ambulance helicopters, with a rapid response car as an alternative, cover close to 1 million inhabitants in an area of 45,000 km2. Our objective was to assess patterns of emergency medical problems and treatments in HEMS in a geographically large, but sparsely populated region.MethodsData from all HEMS dispatches during 2004–2013 were assessed retrospectively. Information was analyzed with respect to patient treatment and characteristics, in addition to variations in services use during the day, week, and seasons.ResultsA total of 42,456 dispatches were analyzed. One third of the patients encountered were severely ill or injured, and two thirds of these received advanced treatment. Median activation time and on‐scene time in primary helicopter missions were 5 and 11 min, respectively. Most patients (95%) were reached within 45 min by helicopter or rapid response car. Patterns of use did not change. More than one third of all dispatches were declined or aborted, mostly due to no longer medical indication, bad weather conditions, or competing missions.ConclusionOne third of the patients encountered were severely ill or injured, and more than two thirds of these received advanced treatment. HEMS use did not change over the 10‐year period, however HEMS use peaked during daytime, weekends, and the summer. More than one third of all dispatches were declined or aborted.

Response time in the emergency services. Systematic review

“…Figure 3 summarizes that a significant portion of the studies dealing with problems related to emergency medical services in order to contribute to decreased response time, resources, coverage and routes, for example, make use of simulation, algorithms and data analysis through descriptive statistics 24,25 . Data evaluation shows that the localities found, positioned mainly in Europe and North America, present a response time in accordance with what is expected for this type of service, having an estimated time of approximately 8 minutes according the WHO 2,[30][31][32][33] .…”

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

“…Previous studies 7,8 have shown a similar demographic of a higher proportion of road traffic collisions occurring by night and also assaults. These assault victims may suffer blunt or penetrating trauma that may require enhanced medical care.…”

Outcomes after cancelled helicopter emergency medical service missions due to concurrencies: a retrospective cohort study

“…Approximately 30% of all HEMS dispatches are cancelled on the basis of no longer being medically needed . Physician‐staffed mobile medical teams are dispatched with a deliberately low threshold in the Netherlands, resulting in 43.5% of the missions being aborted .…”

“…The municipalities are responsible for primary health care, including first responders and a comprehensive out‐of‐hours GP service; the regional health trusts are responsible for ground, boat, and air ambulances, as well as hospitals. The HEMS in our region was described previously …”

“…A high rate of concurrencies can be a sign of over‐triage or a low capacity of the HEMS. In Norway 4–5% of HEMS missions are cancelled due to concurrent requests, an incidence that was considered acceptable until now . An unknown proportion of these missions are completed by other HEMS bases.…”