Helicopter EMS: Research Endpoints and Potential Benefits

Thomas, Stephen; Arthur, Ami

doi:10.1155/2012/698562

Cited by 28 publications

(15 citation statements)

References 125 publications

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“…Although the use of TRISS is recommended in HEMS trauma outcome studies, limitations to the analysis must be emphasised. When patients are intubated prior to hospital arrival, a valid in‐hospital GCS scoring for the RTS is impossible.…”

Section: Discussionmentioning

confidence: 99%

Impact of a physician‐staffed helicopter on a regional trauma system: a prospective, controlled, observational study

Hesselfeldt

Steinmetz²,

Jans

et al. 2013

Acta Anaesthesiol Scand

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IntroductionThis study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients.MethodsThis was a prospective, controlled, observational study, involving seven local hospitals and one level I trauma centre using a before and after design. All patients treated by a trauma team within a 5-month period (1 December 2009–30 April 2010) prior to and a 12-month period (1 May 2010–30 April 2011) after implementing a PS-HEMS were included.We compared time from dispatch of the first ground ambulance to arrival in the trauma centre for patients with Injury Severity Score (ISS) > 15. Secondary end points were the proportion of secondary transfers and 30-day mortality.ResultsWe included 1788 patients, of which 204 had an ISS > 15. The PS-HEMS transported 44 severely injured directly to the trauma centre resulting in a reduction of secondary transfers from 50% before to 34% after implementation (P = 0.04). Median delay for definitive care for severely injured patients was 218 min before and 90 min after implementation (P < 0.01). The 30-day mortality was reduced from 29% (16/56) before to 14% (21/147) after PS-HEMS (P = 0.02). Logistic regression showed PS-HEMS had an odds ratio (OR) for survival of 6.9 compared with ground transport.ConclusionsImplementation of a PS-HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30-day mortality.

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Section: Discussionmentioning

confidence: 99%

Impact of a physician‐staffed helicopter on a regional trauma system: a prospective, controlled, observational study

Hesselfeldt

Steinmetz²,

Jans

et al. 2013

Acta Anaesthesiol Scand

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“…It's necessary for planners to incorporate HEMS "outcomes" on patients, EMS systems, and regionalized care networks. The subject of mechanics of outcomes assessment in HEMS has been addressed in detail in a 2012 review [12]. Highlights and recent advancements will be covered in this section.…”

Section: Outcomes Assessment In Hemsmentioning

confidence: 99%

Helicopter EMS beyond Trauma: Utilization of Air Transport for Non-Trauma Conditions

Thomas¹,

Whelan²,

Williams³

et al. 2013

IJCM

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Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of timecriticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.

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“…In re ghters, sudden cardiac death is the leading cause of death on-duty (3). Helicopter emergency medical service is an important pillar of security in the eld of rescue services (4). It has become an integral part of increasing importance in prehospital emergency medicine (5).…”

Section: Introductionmentioning

confidence: 99%

Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort

Strauß

Dahmen

Hutter

et al. 2020

Preprint

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BackgroundHelicopter emergency medical service (HEMS) is an important part of prehospital emergency medicine. The working conditions lead to high physical stress, especially in rescue operations. To date, little is known about the cardiovascular stress of HEMS crew members in the rescue service. Examinations of professional groups in public security have shown a significant risk in these. The present study aims to determine the cardiovascular stress profile during rescue situations in HEMS crew members.MethodsA total number of 21 (male n=20) HEMS crew members (11 emergency physicians and 10 paramedics) participated in the prospective study. Heart rate (HR), blood pressure (BP) and long-term ECG measurements were recorded at the whole operation day. The changes of measurements during rescue operation (in total 52 operations) were compared to these of standby time.ResultsRescue operations lead to increased load on the cardiovascular system. Expression of this is significantly higher BP, HR values and rate of cardiac events compared to standby time. Significantly higher of both, mean and maximal, diastolic and systolic blood pressure were measured on duty. Especially the difference in BP sys mean is 7.4 ± 9.0 mmHg (7.4, CI [5.1; 9.7], p <0.001). HR minimal, mean and maximal were also significantly higher during rescue operations. HR max was 33.7 bpm higher on average than in the standby time (CI [26.2; 40.8], p <0.001). Cardiac events occurred significantly more frequently during the period of rescue operation than in standby time hours (time volume of 1 hour, p = 0.02).ConclusionsThe results show a significant load on the cardiovascular system during rescue operations in HEMS crew members. This is expressed in a higher occurrence of extrasystoles, HR and BP values during rescue operation than on standby time. Therefore, it is important to carry out a risk stratification of the personnel deployed in the HEMS crew members to prevent cardiovascular risk and events.

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Helicopter EMS: Research Endpoints and Potential Benefits

Cited by 28 publications

References 125 publications

Impact of a physician‐staffed helicopter on a regional trauma system: a prospective, controlled, observational study

Impact of a physician‐staffed helicopter on a regional trauma system: a prospective, controlled, observational study

Helicopter EMS beyond Trauma: Utilization of Air Transport for Non-Trauma Conditions

Rescue operations lead to increased cardiovascular stress in HEMS Crew Members - A prospective pilot study of a German HEMS cohort

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