Pre‐hospital critical care by anaesthesiologist‐staffed pre‐hospital services in <scp>S</scp>candinavia: a prospective population‐based study

Krüger, Andreas; Lossius, Hans Morten; Mikkelsen, Søren; Kurola, Jouni; Castrèn, Maaret; Skogvoll, Eirik

doi:10.1111/aas.12181

Cited by 31 publications

(45 citation statements)

References 29 publications

(29 reference statements)

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“…In primary emergency helicopter missions, 97.7% of patients were reached within the first hour after dispatch. This result compares well with Krüger et al, who reported 7 min of median activation time and 90% of patients reached within the first hour, but rural HEMS and large SAR helicopters were included in their studies 3, 14. A small helicopter with the crew residing at the HEMS base reduces activation time and thus response time.…”

Section: Discussionsupporting

confidence: 85%

“…In addition, the advantage of an experienced anesthesiologist capable of early and sound clinical judgment may be of more value than performing advanced interventions, as the avoidance of an intervention is best practice in some cases. Other researchers have found that advanced treatment was performed in only 23.1% of HEMS missions, but they included several rural services and used a different study design 14. The use of HEMS has changed slightly in recent years, with a focus on rapid transport to a hospital with appropriate medical, high‐tech interventions in patients suffering myocardial infarction or stroke.…”

Section: Discussionmentioning

confidence: 99%

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

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

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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.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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

Østerås

Brattebø

Heltne

2015

Acta Anaesthesiol Scand

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“…It was also associated with more and faster transports directly to a trauma centre compared to dispatch by a paramedic at the dispatch centre 25. A Scandinavian study on anaesthesiologist‐staffed pre‐hospital services found a population incidence of critical illness or injury of 11 per 10,000 person‐years in Norway, based on deranged vital signs, advanced medical procedures performed, and advanced medication given 2. The proportion of trauma patients in the study was 39%, and 27% were considered to have severely deranged vital signs 2…”

Section: Discussionmentioning

confidence: 99%

“…Systems differ between countries, as does the use of physicians vs. paramedics. Both offer extended skills and treatment modalities as compared to ordinary ground ambulances 2. The advanced pre‐hospital care may be delivered through Helicopter Emergency Medical Services systems or rapid response/emergency cars (collectively designated as HEMS).…”

mentioning

confidence: 99%

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Are severely injured trauma victims in Norway offered advanced pre‐hospital care? National, retrospective, observational cohort

Wisborg

Ellensen

Svege

et al. 2017

Acta Anaesthesiol Scand

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BackgroundStudies of severely injured patients suggest that advanced pre‐hospital care and/or rapid transportation provides a survival benefit. This benefit depends on the disposition of resources to patients with the greatest need. Norway has 19 Emergency Helicopters (HEMS) staffed by anaesthesiologists on duty 24/7/365. National regulations describe indications for their use, and the use of the national emergency medical dispatch guideline is recommended. We assessed whether severely injured patients had been treated or transported by advanced resources on a national scale.MethodsA national survey was conducted collecting data for 2013 from local trauma registries at all hospitals caring for severely injured patients. Patients were analysed according to hospital level; trauma centres or acute care hospitals with trauma functions. Patients with an Injury Severity Score (ISS) > 15 were considered severely injured.ResultsThree trauma centres (75%) and 17 acute care hospitals (53%) had data for trauma patients from 2013, a total of 3535 trauma registry entries (primary admissions only), including 604 victims with an ISS > 15. Of these 604 victims, advanced resources were treating and/or transporting 51%. Sixty percent of the severely injured admitted directly to trauma centres received advanced services, while only 37% of the severely injured admitted primarily to acute care hospitals received these services.ConclusionA highly developed and widely distributed HEMS system reached only half of severely injured trauma victims in Norway in 2013.

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Prehospital Release of Patients After Treatment in an Anesthesiologist-Staffed Mobile Emergency Care Unit

et al. 2022

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IMPORTANCEPrehospital treatment and release of patients may reduce unnecessary transports to the hospital and may improve patient satisfaction. However, the safety of patients should be paramount. OBJECTIVE To determine the extent of unplanned emergency department (ED) contacts, shortterm mortality, and diagnostic patterns in patients treated and released by a prehospital anesthesiologist supervising a mobile emergency care unit (MECU). DESIGN, SETTING, AND PARTICIPANTSThis retrospective cohort study used a manual review of prehospital and in-hospital medical records to investigate all living patients who were treated and

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Pre‐hospital critical care by anaesthesiologist‐staffed pre‐hospital services in Scandinavia: a prospective population‐based study

Cited by 31 publications

References 29 publications

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

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

Are severely injured trauma victims in Norway offered advanced pre‐hospital care? National, retrospective, observational cohort

Prehospital Release of Patients After Treatment in an Anesthesiologist-Staffed Mobile Emergency Care Unit

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