scholarly journals Helicopter emergency medical service for time critical interfacility transfers of patients with cardiovascular emergencies

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Lorenz Meuli ◽  
Alexander Zimmermann ◽  
Anna-Leonie Menges ◽  
Mario Tissi ◽  
Stefan Becker ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Aortic Aneurysms ◽  
Medical Services ◽  
Emergency Medical ◽  
Mission Duration ◽  
Vascular Emergencies ◽  
Road Distance

Abstract Background The goal of improving quality through centralisation of specialised medical services must be balanced against potential harm caused by delayed access to emergency treatments in rural areas. This study aims to assess the duration of transfers of critically ill patients with cardiovascular emergencies from smaller hospitals to major medical centres by a helicopter emergency medical service (HEMS) in Switzerland. Methods This retrospective observational cohort study includes all consecutive emergency interfacility transfers (IFTs) conducted by Switzerland’s largest HEMS provider between July 3rd, 2019, and March 31st, 2021. All patients with acute myocardial infarction, non-traumatic strokes, ruptured aortic aneurysms, and other acute vascular emergencies were included. The duration and distance of each HEMS IFT were compared to calculated distances and duration of travel for the same missions using ground-based transportation (GEMS). The ground-based mission distance beyond which the total mission duration of HEMS is expected to be faster than GEMS was calculated. Findings A total of 645 patients were transferred for stroke (n = 364), myocardial infarction (n = 252) and other acute vascular emergencies (n = 29). The median total mission duration from emergency call to landing at the destination was 59.9 (IQR 51.5 to 70.5) minutes. The median road distance for the same missions was 60 (IQR 43 to 72) km. Regression analysis revealed that HEMS is expected to be faster if the road distance is more than 51.3 km. Interpretation Centralisation of specialised medical services should be accompanied by a comprehensive and specialised rescue chain. HEMS in Switzerland ensures time-sensitive IFT in medical emergencies, even in topographically challenging terrain. Graphical Abstract

scholarly journals Airway Management Difficulties in a Helicopter Emergency Medical Service (HEMS): A Retrospective Observational Study of 676 Out-of-Hospital Intubations

2021 ◽  
Author(s):  
Urs Pietsch ◽  
Raphael Müllner ◽  
Lorenz Theiler ◽  
Volker Wenzel ◽  
Lorenz Meuli ◽  
...  
Keyword(s):  
Airway Management ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Ventilatory Support ◽  
Helicopter Emergency Medical Service ◽  
Medical Services ◽  
Emergency Medical ◽  
Advanced Airway ◽  
Number Of Patients

Abstract Background: Airway management is a key skill in any helicopter emergency medical service (HEMS). Successful intubation is less often than in the hospital, and alternative forms of airway management are needed more often. Methods: Retrospective observational cohort study in an anaesthesiologist-staffed HEMS in Switzerland. Patients charts from all scene calls (n=9035) that took place between June 2016 and May 2017 (12 months) were analysed. The primary outcome parameter was intubation success rate. Secondary parameters included number of patients intubated by ground-based emergency medical services, alternative devices used, and comparison of patients with and without difficulties in airway management. Results: A total of 676 patients with invasive ventilatory support were identified. Difficulties in airway management were rare, occurring in 44 (6.5%) patients, and trauma was significantly more common (59.1% vs. 38.6%, p<0.001). In 335 (49.6%) patients, advanced airway management had already been initiated by Ground emergency medical services upon arrival of the HEMS. Paramedics had significantly more exposure to patients needing prehospital anaesthesia than the HEMS physicians; median 12 (IQR 9 to 17.5) versus 3 (IQR 2 to 6), p<0.001.Conclusion: Despite overall high success rates for endotracheal intubation in the physician-staffed service, each physician gets little real-life experience with advanced airway management in the field, highlighting the importance of a solid basic competence such as anaesthesiology and additional training. Direct laryngoscopy is still a valuable skill and an important Plan B in difficult airway situations in which factors such as fogging, blood, bright radiation on the video laryngoscopes screen, impaired the success of video laryngoscopes intubation.

Feedback to Emergency Medical Services Providers: The Good, the Bad, and the Ignored

1997 ◽  
Vol 12 (2) ◽  
pp. 74-77 ◽  
Author(s):  
Elisabeth F. Mock ◽  
Keith D. Wrenn ◽  
Seth W. Wright ◽  
T. Chadwick Eustis ◽  
Corey M. Slovis
Keyword(s):  
Emergency Department ◽  
Emergency Medical Services ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Service Providers ◽  
Medical Services ◽  
Emergency Medical Service System ◽  
Constructive Feedback ◽  
Emergency Medical ◽  
Emergency Medical Service Provider

AbstractHypothesis:To determine the type and frequency of immediate unsolicited feedback received by emergency medical service (EMS) providers from patients or their family members and emergency department (ED) personnel.Methods:Prospective, observational study of 69 emergency medical services providers in an urban emergency medical service system and 12 metropolitan emergency departments. Feedback was rated by two medical student observers using a prospectively devised original scale.Results:In 295 encounters with patients or family, feedback was rated as follows: 1) none in 224 (76%); 2) positive in 51 (17%); 3) negative in 19 (6%); and 4) mixed in one (<1%). Feedback from 254 encounters with emergency department personnel was rated as: 1) none in 185 (73%); 2) positive in 46 (18%); 3) negative in 21 (8%); and 4) mixed in 2 (1%). Patients who had consumed alcohol were more likely to give negative feedback than were patients who had not consumed alcohol. Feedback from emergency department personnel occurred more often when the emergency medical service provider considered the patient to be critically ill.Conclusion:The two groups provided feedback to emergency medical service providers in approximately one quarter of the calls. When feedback was provided, it was positive more than twice as often as it was negative. Emergency physicians should give regular and constructive feedback to emergency medical services providers more often than currently is the case.

Prehospital transfusion of red cell concentrates in a paramedic-staffed helicopter emergency medical service

2017 ◽  
Vol 30 (2) ◽  
pp. 236-241 ◽  
Author(s):  
Stefan Heschl ◽  
Emily Andrew ◽  
Anthony de Wit ◽  
Stephen Bernard ◽  
Marcus Kennedy ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Red Cell ◽  
Emergency Medical
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