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

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Lorenz Meuli¹  Anna-Leonie Menges¹  Alexander Zimmermann¹  Stefan Becker²  Mario Tissi²  Urs Pietsch³  Roland Albrecht³ 

[1] Department of Vascular Surgery, University Hospital Zurich, Raemistrasse 100, CH-8006, Zurich, Switzerland;Swiss Air-Ambulance, Rega (Rettungsflugwacht/Guarde Aérienne), Swiss Air-Rescue, Zurich, Switzerland;Swiss Air-Ambulance, Rega (Rettungsflugwacht/Guarde Aérienne), Swiss Air-Rescue, Zurich, Switzerland;Department of Anesthesiology and Intensive Care Medicine, Cantonal Hospital St.Gallen, St. Gallen, Switzerland;Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland;

关键词: Centralisation;    Interfacility transfers;    Cardiovascular emergencies;    Helicopter emergency medical service;    HEMS;    Ground emergency medical service;    GEMS;    rAAA;    Stroke;    Myocardial infarction;   

DOI  :  10.1186/s13049-021-00981-4

来源: Springer

【 摘 要 】

BackgroundThe 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.MethodsThis 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.FindingsA 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.InterpretationCentralisation 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

【 授权许可】

CC BY