scholarly journals Mechanical Chest Compression Devices in the Helicopter Emergency Medical Service in Switzerland

2020 ◽  
Author(s):  
Urs Pietsch ◽  
David Reiser ◽  
Volker Wenzel ◽  
Jürgen Knapp ◽  
Mario Tissi ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Chest Compression ◽  
Medical Service ◽  
Service Providers ◽  
Helicopter Emergency Medical Service ◽  
Spontaneous Circulation ◽  
Trauma Patients ◽  
Medical Systems ◽  
Mechanical Chest Compression ◽  
Emergency Medical

Abstract Background Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter emergency medical systems (HEMS), which have limitations regarding loading weight and space and typically operate in rural and remote areas, whether MCDs have benefits for patients is still unknown. The aim of this study was to evaluate the use of MCDs in a large Swiss HEMS system. Materials and Methods We conducted a retrospective observational study of all HEMS missions of Swiss Air rescue Rega between January 2014 and June 2016 with the use an MCD (Autopulse®). Details of MCD use and patient outcome are reported from the medical operation journals and the hospitals’ discharge letters. Results MCDs were used in 626 HEMS missions and 590 patients (94%) could be included. 478 (81%) were primary missions and 112 (19%) were interhospital transfers. 49 of the patients in primary missions were loaded under ongoing CPR with MCDs. In the patients loaded after return of spontaneous circulation (ROSC), 20 (7%) experienced a second CA during the flight. In interhospital transfers 102 (91%) only needed standby use of the MCD. Five (4.5%) patients were loaded into the helicopter with ongoing CPR. Five (4.5%) patients went into CA during flight and the MCD had to be activated. Conclusion We conclude that equipping HEMS with MCDs may be beneficial, with non-trauma patients potentially benefitting more than trauma patients.

scholarly journals Mechanical Chest Compression Devices in the Helicopter Emergency Medical Service in Switzerland

2020 ◽  
Author(s):  
Urs Pietsch ◽  
David Reiser ◽  
Volker Wenzel ◽  
Jürgen Knapp ◽  
Mario Tissi ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Chest Compression ◽  
Medical Service ◽  
Service Providers ◽  
Helicopter Emergency Medical Service ◽  
Spontaneous Circulation ◽  
Trauma Patients ◽  
Medical Systems ◽  
Mechanical Chest Compression ◽  
Emergency Medical

Abstract Background: Over the past years, several emergency medical service providers have introduced mechanical chest compression devices (MCDs) in their protocols for cardiopulmonary resuscitation (CPR). Especially in helicopter emergency medical systems (HEMS), which have limitations regarding loading weight and space and typically operate in rural and remote areas, whether MCDs have benefits for patients is still unknown. The aim of this study was to evaluate the use of MCDs in a large Swiss HEMS system.Materials and Methods: We conducted a retrospective observational study of all HEMS missions of Swiss Air rescue Rega between January 2014 and June 2016 with the use of an MCD (Autopulse®). Details of MCD use and patient outcome are reported from the medical operation journals and the hospitals’ discharge letters. Results: MCDs were used in 626 HEMS missions, and 590 patients (94%) could be included. 478 (81%) were primary missions and 112 (19%) were interhospital transfers. Forty-nine of the patients in primary missions were loaded under ongoing CPR with MCDs. Of the patients loaded after return of spontaneous circulation (ROSC), 20 (7%) experienced a second CA during the flight. In interhospital transfers, 102 (91%) only needed standby use of the MCD. Five (5%) patients were loaded into the helicopter with ongoing CPR. Five (5%) patients went into CA during flight and the MCD had to be activated. A shockable cardiac arrhythmia was the only factor significantly associated with better survival in resuscitation missions using MCD (OR 0.176, 95% confidence interval 0.084 to 0.372, p<0.001).Conclusion: We conclude that equipping HEMS with MCDs may be beneficial, with non-trauma patients potentially benefitting more than trauma patients.

Utilization Criteria for Prehospital Ultrasound in a Canadian Critical Care Helicopter Emergency Medical Service: Determining Who Might Benefit

2017 ◽  
Vol 32 (5) ◽  
pp. 536-540 ◽  
Author(s):  
Domhnall O’Dochartaigh ◽  
Matthew Douma ◽  
Chris Alexiu ◽  
Shell Ryan ◽  
Mark MacKenzie
Keyword(s):  
Critical Care ◽  
Emergency Medical Service ◽  
Medical Service ◽  
Helicopter Emergency Medical Service ◽  
Outcome Variable ◽  
Trauma Patients ◽  
Medical Patients ◽  
Shock Index ◽  
Patient Acuity ◽  
Emergency Medical

AbstractIntroductionPrehospital ultrasound (PHUS) assessments by physicians and non-physicians are performed on medical and trauma patients with increasing frequency. Prehospital ultrasound has been shown to be of benefit by supporting interventions.ProblemWhich patients may benefit from PHUS has not been clearly identified.MethodsA multi-variable logistic regression analysis was performed on a previously created retrospective dataset of five years of physician- and non-physician-performed ultrasound scans in a Canadian critical care Helicopter Emergency Medical Service (HEMS). For separate medical and trauma patient groups, the a-priori outcome assessed was patient characteristics associated with the outcome variable of “PHUS-supported intervention.”ResultsBoth models were assessed (Likelihood Ratio, Score, and Wald) as a good fit. For medical patients, the characteristics of heart rate (HR) and shock index (SI) were found to be most significant for an intervention being supported by PHUS. An extremely low HR was found to be the most significant (OR=15.86 [95% confidence interval (CI), 1.46-171.73]; P=.02). The higher the SI, the more likely that an intervention was supported by PHUS (SI 0.9 to<1.3: OR=9.15 [95% CI, 1.36-61.69]; P=.02; and SI 1.3+: OR=8.37 [95% CI, 0.69-101.66]; P=.09). For trauma patients, the characteristics of Prehospital Index (PHI) and SI were found to be most significant for PHUS support. The greatest effect was PHI, where increasing ORs were seen with increasing PHI (PHI 14-19: OR=13.36 [95% CI, 1.92-92.81]; P=.008; and PHI 20-24: OR=53.10 [95% CI, 4.83-583.86]; P=.001). Shock index was found to be similar, though, with lower impact and significance (SI 0.9 to<1.3: OR=9.11 [95% CI, 1.31-63.32]; P=.025; and SI 1.3+: OR=35.75 [95% CI, 2.51-509.81]; P=.008).Conclusions:In a critical care HEMS, markers of higher patient acuity in both medical and trauma patients were associated with occurrences when an intervention was supported by PHUS. Prospective study with in-hospital follow-up is required to confirm these hypothesis-generating results.O’DochartaighD, DoumaM, AlexiuC, RyanS, MacKenzieM. Utilization criteria for prehospital ultrasound in a Canadian critical care Helicopter Emergency Medical Service: determining who might benefit. Prehosp Disaster Med. 2017;32(5):536–540.

scholarly journals Helicopter Emergency Medical Service and Hospital Treatment Levels Affect Survival in Pediatric Trauma Patients

2021 ◽  
Vol 10 (4) ◽  
pp. 837
Author(s):  
Felix Marius Bläsius ◽  
Klemens Horst ◽  
Jörg Christian Brokmann ◽  
Rolf Lefering ◽  
Hagen Andruszkow ◽  
...  
Keyword(s):  
Emergency Medical Service ◽  
Medical Service ◽  
Pediatric Patients ◽  
Pediatric Trauma ◽  
Helicopter Emergency Medical Service ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Emergency Medical ◽  
Level Ii ◽  
Level I

(1) Background: Data on the effects of helicopter emergency medical service (HEMS) transport and treatment on the survival of severely injured pediatric patients in high-level trauma centers remain unclear. (2) Methods: A national dataset from the TraumaRegister DGU® was used to retrospectively compare the mortality rates among severely injured pediatric patients (1–15 years) who were transported by HEMS to those transported by ground emergency medical service (GEMS) and treated at trauma centers of different treatment levels (levels I–III). (3) Results: In total, 2755 pediatric trauma patients (age: 9.0 ± 4.8 years) were included in this study over five years. Transportation by HEMS resulted in a significant survival benefit compared to GEMS (odds ratio (OR) 0.489; 95% confidence interval (CI): 0.282–0.850). Pediatric trauma patients treated in level II or III trauma centers showed 34% and fourfold higher in-hospital mortality risk than those in level I trauma centers (level II: OR 1.34, 95% CI: 0.70–2.56; level III: OR 4.63, 95% CI: 1.33–16.09). (4) Conclusions: In our national pediatric trauma cohort, both HEMS transportation and treatment in level I trauma centers were independent factors of improved survival in pediatric trauma patients.

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