Merits and capabilities of helicopter emergency medical service (HEMS) in traumatized patients.

Since the introduction of helicopter emergency medical service (HEMS) into the civilian rescue system, there is an ongoing discussion on its potential benefits in terms of time- and cost-effectiveness as well as clinical outcome improvement. Currently, the use of HEMS seems to provide a survival benefit in traumatized patients due to several aspects compared to ground emergency medical service (GEMS). First of all, HEMS facilitate rapid transport from the scene to hospital based on increased transportation velocity. Furthermore, HEMS medical crew members are experienced in trauma management resulting in improved on-scene management and patients' triaging. However, these aspects should be considered carefully as specific circumstances referring to rescue teams, on-scene management as well as preclinical durations, triaging of trauma patients and subsequent treatment at different hospitals have to be attended. In the present review current aspects of HEMS compared to GEMS are discussed.

[1]  E W Steyerberg,et al.  Prehospital interventions: time wasted or time saved? An observational cohort study of management in initial trauma care , 2008, Emergency Medicine Journal.

[2]  G. Nardi,et al.  HEMS VS. GROUND-BLS CARE IN TRAUMATIC CARDIAC ARREST , 2005, Prehospital Emergency Care.

[3]  D. Davis,et al.  The impact of hypoxia and hyperventilation on outcome after paramedic rapid sequence intubation of severely head-injured patients. , 2004, The Journal of trauma.

[4]  S. Wedel,et al.  Helicopter transport and blunt trauma mortality: a multicenter trial. , 2002, The Journal of trauma.

[5]  A. Localio,et al.  Cost-effectiveness analysis of helicopter EMS for trauma patients. , 1997, Annals of emergency medicine.

[6]  E. D. L. de Lange-de Klerk,et al.  Benefit of Helicopter Emergency Medical Services on trauma patient mortality in the Netherlands? , 2012, Injury.

[7]  C. Krettek,et al.  Experimental Trauma Models: An Update , 2011, Journal of biomedicine & biotechnology.

[8]  J. Nicholl,et al.  The Cost and Effectiveness of the London Helicopter Emergency Medical Service , 1996, Journal of health services research & policy.

[9]  Belinda J Gabbe,et al.  Prehospital prediction of the severity of blunt anatomic injury. , 2008, The Journal of trauma.

[10]  S. Neel.  Army aeromedical evacuation procedures in Vietnam: implications for rural America. , 1968, JAMA.

[11]  Colleen Buono,et al.  The impact of aeromedical response to patients with moderate to severe traumatic brain injury. , 2005, Annals of emergency medicine.

[12]  Lawrence H Brown,et al.  Guidelines for Field Triage of Injured Patients: Recommendations of the National Expert Panel on Field Triage , 2009, Pediatrics.

[13]  D. Greenhalgh,et al.  Cost-effective use of helicopters for the transportation of patients with burn injuries. , 2000, The Journal of burn care & rehabilitation.

[14]  J. Williams,et al.  Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients. , 1993, The Journal of trauma.

[15]  C. McCowan,et al.  Outcomes of pediatric trauma patients transported from rural and urban scenes. , 2008, Air medical journal.

[16]  J. Nicholl,et al.  Effects of London helicopter emergency medical service on survival after trauma , 1995, BMJ.

[17]  M. Rosko,et al.  A critical analysis of on-scene helicopter transport on survival in a statewide trauma system. , 1998, The Journal of trauma.

[18]  C. Waydhas,et al.  Early intubation in severely injured patients. , 1994, European journal of emergency medicine : official journal of the European Society for Emergency Medicine.

[19]  Alex D. Mitchell,et al.  Air versus ground transport of major trauma patients to a tertiary trauma centre: a province-wide comparison using TRISS analysis. , 2005, Canadian journal of surgery. Journal canadien de chirurgie.

[20]  Neel Sh.  Helicopter evacuation in Korea. , 1955 .

[21]  P. Dissmann,et al.  The experience of Teesside helicopter emergency services: doctors do not prolong prehospital on-scene times , 2006, Emergency Medicine Journal.

[22]  J. Owen,et al.  One year's trauma mortality experience at Brooke Army Medical Center: is aeromedical transportation of trauma patients necessary? , 1999, Military medicine.

[23]  C. Probst,et al.  Comparison of helicopter and ground emergency medical service: a retrospective analysis of a German rescue helicopter base. , 2012, Technology and health care : official journal of the European Society for Engineering and Medicine.

[24]  C. McCowan,et al.  Outcomes of Blunt Trauma Victims Transported by HEMS from Rural andUrban Scenes , 2007, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[25]  S. Ruchholtz,et al.  Prehospital intubation in severe thoracic trauma without respiratory insufficiency: a matched-pair analysis based on the Trauma Registry of the German Trauma Society. , 2002, The Journal of trauma.

[26]  B. Jennett,et al.  Assessment of coma and impaired consciousness. A practical scale. , 1974, Lancet.

[27]  S. Oppe,et al.  The effect of medical care by a helicopter trauma team on the probability of survival and the quality of life of hospitalised victims. , 2001, Accident; analysis and prevention.

[28]  L. Leenen,et al.  A systematic review of randomized controlled trials exploring the effect of immunomodulative interventions on infection, organ failure, and mortality in trauma patients , 2010, Critical care.

[29]  H. Cleveland,et al.  A civilian air emergency service: a report of its development, technical aspects, and experience. , 1976, The Journal of trauma.

[30]  E. Steyerberg,et al.  Helicopter emergency medical services (HEMS): impact on on-scene times. , 2007, The Journal of trauma.

[31]  A. Nakstad,et al.  Landing sites and intubation may influence helicopter emergency medical services on-scene time. , 2011, The Journal of emergency medicine.

[32]  E. Steyerberg,et al.  Cost‐effectiveness and quality‐of‐life analysis of physician‐staffed helicopter emergency medical services , 2009, The British journal of surgery.

[33]  W. Baxt,et al.  The impact of a physician as part of the aeromedical prehospital team in patients with blunt trauma. , 1987, JAMA.

[34]  A. Bleetman,et al.  Influence of air ambulance doctors on on-scene times, clinical interventions, decision-making and independent paramedic practice , 2009, Emergency Medicine Journal.

[35]  K. Willett,et al.  Is it the H or the EMS in HEMS that has an impact on trauma patient mortality? A systematic review of the evidence , 2010, Emergency Medicine Journal.

[36]  A. V. van Vugt,et al.  Beneficial effect of helicopter emergency medical services on survival of severely injured patients , 2004, The British journal of surgery.

[37]  Julius D. Cheng,et al.  Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury. , 2010, The Journal of trauma.

[38]  H Greig,et al.  Abbreviated Injury Scale and Injury Severity Score: a scoring chart. , 1985, The Journal of trauma.

[39]  Bette C Liu,et al.  An investigation into the cost, coverage and activities of Helicopter Emergency Medical Services in the state of New South Wales, Australia. , 2011, Injury.

[40]  G. Franklin,et al.  Systemic inflammation after trauma. , 2007, Injury.

[41]  W. Haddon,et al.  The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. , 1974, The Journal of trauma.

[42]  J. Svenson,et al.  Is air transport faster? A comparison of air versus ground transport times for interfacility transfers in a regional referral system. , 2006, Air medical journal.

[43]  H. Zwipp,et al.  Impact of helicopter transport and hospital level on mortality of polytrauma patients. , 2004, The Journal of trauma.

[44]  Shahram Lotfipour,et al.  Guidelines for Field Triage of Injured Patients , 2013, The western journal of emergency medicine.

[45]  Schwartz Rj,et al.  A comparison of ground paramedics and aeromedical treatment of severe blunt trauma patients. , 1990 .

[46]  W G Baxt,et al.  The impact of a rotorcraft aeromedical emergency care service on trauma mortality. , 1983, JAMA.

[47]  D. Davis,et al.  Emergency medical services intervals and survival in trauma: assessment of the "golden hour" in a North American prospective cohort. , 2010, Annals of emergency medicine.

[48]  P. Cameron,et al.  Helicopter retrieval of primary trauma patients by a paramedic helicopter service. , 1993, The Australian and New Zealand journal of surgery.

[49]  M Richter,et al.  Trauma care in Germany. , 2003, Injury.

[50]  Wendy Dryden,et al.  Timing is everything: delayed intubation is associated with increased mortality in initially stable trauma patients. , 2011, The Journal of surgical research.

[51]  Hospital-based rotorcraft aeromedical emergency care services and trauma mortality: a multicenter study. , 1985 .

[52]  T. Coats,et al.  Interpretation of the Ws statistic: application to an integrated trauma system. , 1997, The Journal of trauma.

[53]  K. Yeomans,et al.  The effect of air medical transport on survival after trauma in Johannesburg, South Africa. , 2002, South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde.

[54]  S. Jan,et al.  A systematic review of the costs and benefits of helicopter emergency medical services. , 2010, Injury.

[55]  C. Cook,et al.  Reducing overtriage without compromising outcomes in trauma patients. , 2001, Archives of surgery.

[56]  B. Munford,et al.  Air medical scene response to blunt trauma: effect on early survival , 1998, The Medical journal of Australia.

[57]  H. Evans,et al.  Helicopter transport: help or hindrance? , 2011, Current opinion in critical care.

[58]  L. Jacobs,et al.  Helicopter air medical transport: ten-year outcomes for trauma patients in a New England program. , 1999, Connecticut medicine.

[59]  D. Clark,et al.  Guidelines for emergency tracheal intubation immediately after traumatic injury. , 2003, The Journal of trauma.

[60]  N Clay Mann,et al.  Injury mortality following the loss of air medical support for rural interhospital transport. , 2002, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[61]  J. Sherck,et al.  The utility of helicopter transport of trauma patients from the injury scene in an urban trauma system. , 2002, The Journal of trauma.

[62]  Bryan E Bledsoe,et al.  Helicopter scene transport of trauma patients with nonlife-threatening injuries: a meta-analysis. , 2006, The Journal of trauma.

[63]  A. Williams.  EuroQol : a new facility for the measurement of health-related quality of life , 1990 .

[64]  C. Probst,et al.  [Trauma care systems in Germany, USA and Australia. An international comparison]. , 2010, Der Unfallchirurg.

[65]  M. Keel,et al.  Pathophysiology of polytrauma. , 2005, Injury.