Long-distance repatriation by an EMS helicopter.

In Europe, long-distance repatriation flights are usually executed by fixed-wing aircraft. We report an international long-distance repatriation flight by the helicopter emergency medical service (HEMS), with a total flight time of almost 7 hours. The flight itself, the medical requirements, and aviation problems are discussed. The operation of the flight itself was almost uneventful thanks to careful preflight planning; however, it also proved challenging because of national regulations and airspace structures, which were somewhat different from those of Germany. The treatment of the patient during the flight was not affected by the extraordinarily long distance. We conclude that a combination of appropriate preflight planning, radio communication, and close cooperation with legal authorities is the key to accomplishing a successful execution of an international repatriation missions by the HEMS.