Which groups of patients benefit from helicopter evacuation?

Hotvedt, Ragnar; Thoner, J; Sm, Almdahl; Bjørsvik, Geir; Berge, Lillian Nordbø; Sparr, T.; Ytre-Arne, Kjetil; Is, Kristiansen; Førde, Olav Helge; Magnus, Anne; Mamen, K

doi:10.1016/s0140-6736(96)91010-7

Cited by 98 publications

(54 citation statements)

References 17 publications

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“…Some studies do support the use of HEAS arguing that outcome benefit can be shown. [14][15][16] The helicopter has clear advantages in accessing remote rural areas and areas where traffic congestion is a problem. There are, however, certain scenarios where air ambulance transfer is contraindicated.…”

Section: Discussionmentioning

confidence: 99%

Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

Melton

Jain

Kendrick

et al. 2007

annals

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Ann R Coll Surg Engl 2007; 89: [513][514][515][516] 513 Helicopters were used very successfully for the transfer of wounded soldiers from the battlefields in the Korean and Vietnam wars and this model of patient transfer was then put into use in a civilian setting, initially in the US. In 1987, the first helicopter-based ambulance service in the UK was introduced in the Greater London region. 1Although this service carries an emergency physician as crew, it is unique in that respect. All other 15 dedicated HEAS providers in the UK are usually manned by one pilot and two paramedics. Advanced trauma and life-support (ATLS) teaching is that there are three peaks of mortality following major trauma. An early peak is due to patients who will die immediately with fatal injuries, a second peak of patients who will die in the 60 min following trauma and a third peak representing patients who will die of delayed complications of their injuries such as organ failure and sepsis. The second peak of mortality within 60 min of injury (the so-called 'golden hour' in ATLS teaching) represents the patients for whom rapid transfer to an emergency medical care facility from the scene of injury is potentially life-saving. 3The perceived benefit of helicopter transfer is the faster speed of transfer to hospital. This will maximise the proportion of the 'golden hour' spent in a hospital setting where potentially reversible conditions such as tension pneumothorax or cardiac tamponade can be treated. The most commonly used helicopter for HEAS in the UK is the Eurocopter 'Bolkow' 105, 2 which has a maximum speed of 252 km/h, clearly faster than ground ambulance. However, when factors such as mobilisation time, weather conditions, ease of access and the availability of helipad for landing at destination hospitals is considered, quicker transfer by helicopter is not always guaranteed. Many studies have found that patient transfer by helicopter is often not faster than by ground ambulance transfer overall except when large distances (over 45 km) are involved or when roads are poor or traffic conditions bad. These studies have questioned which

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Section: Discussionmentioning

confidence: 99%

Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

Melton

Jain

Kendrick

et al. 2007

annals

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“…FW, fixed wing; RW, rotor wing. bulance staffed with an HEMS crew (pilot, rescue personnel, and anesthesiologist) and a FW air ambulance staffed with an air crew, specialized nurse and an anesthesiologist (Hotvedt et al, 1996). The helicopter operates within a radius of 130 km from the base, including the catchment area of the district general hospital in Harstad.…”

mentioning

confidence: 99%

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Sollid

Munch-Ellingsen

Gilbert

et al. 2003

Journal of Neurotrauma

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The purpose of this study was to survey the time consumed during the pre- and inter-hospital transport of severely head injured patients in Northern Norway. All patients (n = 85) operated for an intracranial mass lesions within 48 h after injury during the 10-year period 1986-1995 were included in this retrospective analysis. Ambulance records, transfer notes, and hospital records were reviewed. The transport of patients was classified as either direct from the trauma scene to the University Hospital (direct admission group) or as an inter-hospital transfer (transfer group). Forty-seven (55%) patients were in the direct admission group, and 38 (45%) were transferred through another hospital. The majority of patients (81%) were transported by air ambulance. Median time from injury to arrival in the emergency room was 5 (1-44) h. Time necessary for transport was significantly (p < 0.001) shorter in the direct admission group (median 3 h) compared to the transfer group (median 8 h). The inter-hospital transfer time was < or = 3 h in 17%. Clearly, the advanced air ambulance service in Northern Norway makes rapid inter-hospital transfer possible despite extremely long geographical distances. Our findings indicate that this possibility is not always utilized.

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“…Diese Belastung setzt sich aus vielen verschiedenen Komponenten zusammen. Neben mentalen Auswirkungen wie Angst sind physikalische Einflüsse entscheidend [2,4,8,10,14].…”

Section: Diskussionunclassified

“…Die Wichtigkeit der Aufstellung valider Selektionskriterien für Patienten, die besonders vom Hubschraubertransport profitieren, wird hervorgehoben [4]. Es gibt jedoch einige klinische Hinweise aus dem Vergleich von Boden-und Hubschraubertransport [8,14,19,22,24,25].…”

Section: Diskussionunclassified

Hämodynamische, endokrinologische und testpsychologische Untersuchungen an Probanden während Rettungshubschrauberflügen

2002

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Which groups of patients benefit from helicopter evacuation?

Cited by 98 publications

References 17 publications

Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

Helicopter Emergency Ambulance Service (HEAS) Transfer: An Analysis of Trauma Patient Case-Mix, Injury Severity and Outcome

Pre- and Inter-Hospital Transport of Severely Head-Injured Patients in Rural Northern Norway

Hämodynamische, endokrinologische und testpsychologische Untersuchungen an Probanden während Rettungshubschrauberflügen

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