When is an anesthesiologist needed in a helicopter emergency medical service in northern Norway?

Ulvik, Atle; Carlsen, Anders Wetting; Rannestad, Bård Stian

doi:10.1034/j.1399-6576.2002.460705.x

Cited by 9 publications

(5 citation statements)

References 3 publications

(4 reference statements)

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“…1996, concluded that Norwegian GPs could provide adequate treatment to more than half of the patients treated by an HEMS doctor [28]. Another study on HEMS patients from the northern part of Norway concluded that GPs often started important medical treatment, if needed, before HEMS arrival [29].…”

Section: Discussionmentioning

confidence: 99%

Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway

Zakariassen

Østerås

Nystøyl

et al. 2019

Scandinavian Journal of Primary Health Care

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Background: Despite the potential benefits of physician-staffed Helicopter Emergency Medical Service (HEMS), many dispatches to primary HEMS missions in Norway are cancelled before patient encounter. Information is sparse regarding the health consequences when medically indicated HEMS missions are cancelled and the patients are treated by a GP and ambulance staff only. We aimed to estimate the potential loss of life years for patients in these situations. Method: We included all HEMS requests in the period 2010-2013 from Sogn and Fjordane County that were medically indicated but subsequently cancelled. This provided a selection of patients, with the purpose of studying cancellations independently of the patient's medical status A multidisciplinary expert panel retrospectively assessed each patient's potential loss of life years due to the lack of helicopter transport and intervention by a HEMS physician. Results: The study included 184 patients from 176 missions. Because of unavailable HEMS, seven patients (4%) were anticipated to have lost a total of 18 life years. Three patients suffered from myocardial infarction, three from stroke and one from abdominal haemorrhage. The main contribution from HEMS care in these seven cases might have been rapid transport to definitive care. The probability of a patient losing life years when in need of HEMS evacuation was found to be 0.2%. Conclusion: During the four years period seven patients lost 18 life years. Lack of rapid transport seems to be the primary cause of lost life years in this specific geographical area. KEY POINTS Knowledge about to what extent HEMS contributes to an increased survival and a better outcome for patients is limited. Compared to similar studies on life years gained the estimated loss of life years was minor when HEMS evacuation was unavailable in this rural area. The findings indicates that lack of rapid HEMS transport was the primary cause of the estimated loss of life years.

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Section: Discussionmentioning

confidence: 99%

Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway

Zakariassen

Østerås

Nystøyl

et al. 2019

Scandinavian Journal of Primary Health Care

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“…One study demonstrated gained life years among patients treated by an anaesthesiologist [16], while another showed that two-thirds of severely ill or injured patients received advanced treatment [10]. However, other studies have concluded that the majority of patients did not receive medical treatment requiring an anaesthesiologist, and thus could thus have been transported by ground ambulance [17,18]. Our findings may indicate the same, though it is difficult to compare the results of different studies due to the difference among study areas, methodological variations, and challenges intrinsic to RCTs in emergency medicine research.…”

Section: Discussionmentioning

confidence: 99%

Treatment, transport, and primary care involvement when helicopter emergency medical services are inaccessible: a retrospective study

Nystøyl

Hunskaar

Breidablik

et al. 2018

Scandinavian Journal of Primary Health Care

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Objective: To examine handling of cancelled helicopter emergency medical services (HEMS) missions with a persisting medical indication. Design: Retrospective observational study. Setting and subjects: Cancelled HEMS missions with persisting medical indication within Sogn og Fjordane county in Norway during the period of 2010–2013. Both primary and secondary missions were included. Main outcome measures: Primary care involvement, treatment and cooperation within the prehospital system. Results: Our analysis included 172 missions with 180 patients. Two-thirds of the patients (118/180) were from primary missions. In 95% (112/118) of primary missions, GPs were alerted, and they examined 62% (70/112) of these patients. Among the patients examined by a GP, 30% (21/70) were accompanied by a GP during transport to hospital. GP involvement did not differ according to time of day ( p = 0.601), diagnostic group ( p = 0.309), or patient’s age ( p = 0.409). In 41% of primary missions, the patients received no treatment or oxygen only during transport. Among the secondary missions, 10% (6/62) of patients were intubated or received non-invasive ventilation and were accompanied by a physician or nurse anaesthetist during transport. Conclusions: Ambulance workers and GPs have an important role when HEMS is unavailable. Our findings indicated good collaboration among the prehospital personnel. Many of the patients were provided minimal or no treatment, and treatment did not differ according to GP involvement. Key Points Knowledge about handling and involvement of prehospital services in cancelled helicopter emergency medical services (HEMS) missions are scarce. Ambulance workers and general practitioners have an important role when HEMS is unavailable Minimal or no treatment was given to a large amount of the patients, regardless of which health personnel who encountered the patient.

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“…A study of a medically staffed helicopter ambulance service in Norway found that the skills of an anaesthesiologist were not required in more than 95% of ambulance helicopter journeys, 3 although this study only examined the primary response service and excluded inter-hospital transfers. On the basis of our experience, it seems that the possession of advanced airway skills and the ability to independently perform rapid sequence intubation is a mandatory skill for medical staff undertaking aeromedical retrieval work.…”

Section: Discussionmentioning

confidence: 99%

Aeromedical retrieval to a university hospital emergency department in Scotland

Caldow

Parke

Graham

et al. 2004

Emergency Medicine Journal

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When is an anesthesiologist needed in a helicopter emergency medical service in northern Norway?

Abstract: In our rural area, with a widely scattered population, 95% of patients received medical treatment not requiring an anesthesiologist. A selective use of the anesthesiologist seems indicated.

Cited by 9 publications

References 3 publications

Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway

Loss of life years due to unavailable helicopter emergency medical service: a single base study from a rural area of Norway

Treatment, transport, and primary care involvement when helicopter emergency medical services are inaccessible: a retrospective study

Aeromedical retrieval to a university hospital emergency department in Scotland

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