HEMS dispatch: A systematic review

Eaton, Georgette; Brown, Simon; Raitt, James

doi:10.1177/1460408617721565

Cited by 14 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Having the HEMS physician decide on a large amount of cancellations may also lead to decision fatigue [24,25]., increasing the risk for inappropriate cancellations [25]. The effectiveness of the service could potentially be increased by improving dispatch criteria or by flight paramedic interrogation of the caller [26,27].…”

Section: Discussionmentioning

confidence: 99%

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

Saviluoto

Björkman

Olkinuora³

et al. 2020

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

Background: Helicopter Emergency Medical Services (HEMS) play an important role in prehospital care of the critically ill. Differences in funding, crew composition, dispatch criteria and mission profile make comparison between systems challenging. Several systems incorporate databases for quality control, performance evaluation and scientific purposes. FinnHEMS database was incorporated for such purposes following the national organization of HEMS in Finland 2012. The aims of this study are to describe information recorded in the database, data collection, and operational characteristics of Finnish HEMS during 2012-2018. Methods: All dispatches of the six Finnish HEMS units recorded in the national database from 2012 to 2018 were included in this observational registry study. Five of the units are physician staffed, and all are on call 24/7. The database follows a template for uniform reporting in physician staffed pre-hospital services, exceeding the recommended variables of relevant guidelines. Results: The study included 100,482 dispatches, resulting in 33,844 (34%) patient contacts. Variables were recorded with little or no missing data. A total of 16,045 patients (16%) were escorted by HEMS to hospital, of which 2239 (2%) by helicopter. Of encountered patients 4195 (4%) were declared deceased on scene. The number of denied or cancelled dispatches was 66,638 (66%). The majority of patients were male (21,185, 63%), and the median age was 57.7 years. The median American Society of Anesthesiologists Physical Scale classification was 2 and Eastern Cooperative Oncology Group performance class 0. The most common reason for response was trauma representing 26% (8897) of the patients, followed by out-of-hospital cardiac arrest 20% (6900), acute neurological reason excluding stroke 13% (4366) and intoxication and related psychiatric conditions 10% (3318). Blunt trauma (86%, 7653) predominated in the trauma classification.

show abstract

Section: Discussionmentioning

confidence: 99%

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

Saviluoto

Björkman

Olkinuora³

et al. 2020

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

show abstract

“…HEMS teams were dispatched directly in only a minority of the patients with LOC in our cohort. Although robust evidence-based HEMS tasking criteria are available for trauma patients [ 6 , 10 ], service deployment to non-trauma patients is often less guided by strict criteria [ 17 , 18 ]. Historically, the dispatch process in many EMS systems for non-trauma relies on a ‘chief complaint’ creating a cascade of actions and subsequent dispatch of EMS resource.…”

Section: Discussionmentioning

confidence: 99%

“…Emergency medical services (EMS) frequently attend patients with a sudden LOC [ 5 , 6 ]. Cardiac arrest and seizures are amongst the most prevalent causes of LOC attended by EMS, and emergency medical dispatchers in most EMS systems have an established pathway during the 112/999 call to discern if one of these conditions is present.…”

Section: Introductionmentioning

confidence: 99%

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Mohindru¹,

Griggs²,

Coverly³

et al. 2020

BMC Emerg Med

View full text Add to dashboard Cite

Background Sudden loss of consciousness (LOC) in the prehospital setting in the absence of cardiac arrest and seizure activity may be a challenge from a dispatcher’s perspective: The aetiology is varied, with many causes being transient and mostly self-limiting, whereas other causes are potentially life threatening. In this study we aim to evaluate the dispatch of HEMS to patients with LOC of medical origin, by exploring to which patients with a LOC HEMS is dispatched, which interventions HEMS teams perform in these patients, and whether HEMS interventions can be predicted by patient characteristics. Methods We performed retrospective cohort study of all patients with a reported unexplained LOC (e.g. not attributable to a circulatory arrest or seizures) attended by the Air Ambulance Kent, Surrey & Sussex (AAKSS), over a 4-year period (July 2013–December 2017). Primary outcome was defined as the number of HEMS-specific interventions performed in patients with unexplained LOC. Secondary outcome was the relation of clinical- and dispatch criteria with HEMS interventions being performed. Results During the study period, 127 patients with unexplained LOC were attended by HEMS. HEMS was dispatched directly to 25.2% of the patients, but mostly (74.8%) on request of the ground ambulance crews. HEMS interventions were performed in 65% of the patients (Prehospital Emergency Anaesthesia 56%, hyperosmolar therapy 21%, antibiotic/antiviral therapy 8%, vasopressor therapy 6%) and HEMS conveyed most patients (77%) to hospital. Acute neurological pathology was a prevalent underlying cause of unexplained LOC: 38% had gross pathology on their CT-scan upon arrival in hospital. Both GCS (r = − 0.60, p < .001) and SBP (r = 0.31, p < .001) were related to HEMS interventions being performed on scene. A GCS < 13 predicted the need for HEMS interventions in our population with a sensitivity of 94.9% and a specificity 75% (AUC 0.85). Conclusion HEMS dispatchers and ambulance personnel are able to identify a cohort of patients with unexplained LOC of medical origin who suffer from potentially life threatening (mainly neurological) pathology, in whom HEMS specific intervention are frequently required. Presenting GCS can be used to inform the triage process of patients with LOC at an early stage.

show abstract

“…The caller themselves may have been involved in the accident, may be a friend or relative of the critical patient, or may themselves be injured. 13 The ability of a bystander at the scene of a suspected traumatic cardiac arrest to make an accurate assessment may therefore be hampered. 1 While the current early dispatch of HEMS is based on essentially a symptom-based system, other potential factors could be incorporated to help this, for example, the mechanism of incident or injury, the nature and severity, for example, high-speed road traffic accident, rollover and entrapped casualties.…”

Section: Discussionmentioning

confidence: 99%

“… 5 In order to prevent deterioration or achieve a return-of-spontaneous circulation (ROSC) following TCA, early dispatch and rapid response of HEMS teams are required. 13 …”

Section: Introductionmentioning

confidence: 99%

Emergency medical dispatch recognition, clinical intervention and outcome of patients in traumatic cardiac arrest from major trauma: an observational study

et al. 2018

View full text Add to dashboard Cite

ObjectivesThe aim of this study is to describe the demographics of reported traumatic cardiac arrest (TCA) victims, prehospital resuscitation and survival to hospital rate.SettingHelicopter Emergency Medical Service (HEMS) in south-east England, covering a resident population of 4.5 million and a transient population of up to 8 million people.ParticipantsPatients reported on the initial 999 call to be in suspected traumatic cardiac arrest between 1 July 2016 and 31 December 2016 within the trust’s geographical region were identified. The inclusion criteria were all cases of reported TCA on receipt of the initial emergency call. Patients were subsequently excluded if a medical cause of cardiac arrest was suspected.Outcome measuresPatient records were analysed for actual presence of cardiac arrest, prehospital resuscitation procedures undertaken and for survival to hospital rates.Results112 patients were reported to be in TCA on receipt of the 999/112 call. 51 (46%) were found not to be in TCA on arrival of emergency medical services. Of the ‘not in TCA cohort’, 34 (67%) received at least one advanced prehospital medical intervention (defined as emergency anaesthesia, thoracostomy, blood product transfusion or resuscitative thoracotomy). Of the 61 patients in actual TCA, 10 (16%) achieved return-of-spontaneous circulation. In 45 (88%) patients, the HEMS team escorted the patient to hospital.ConclusionA significant proportion of patients reported to be in TCA on receipt of the emergency call are not in actual cardiac arrest but are critically unwell requiring advanced prehospital medical intervention. Early activation of an enhanced care team to a reported TCA call allows appropriate advanced resuscitation. Further research is warranted to determine which interventions contribute to improved TCA survival.

show abstract

HEMS dispatch: A systematic review

Cited by 14 publications

References 17 publications

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

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

Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin

Emergency medical dispatch recognition, clinical intervention and outcome of patients in traumatic cardiac arrest from major trauma: an observational study

Contact Info

Product

Resources

About