Table 2.
Characteristics of patients and medical interventions in human external cargo missions
| Study | Study design | Setting | Patients | Findings |
|---|---|---|---|---|
| Corniche J [10] | Prospective study. Review of primary rescue interventions in all missions involving hoisting of a physician, Switzerland, 1998 to 2002 | 1855 HEMS missions, 156 (8%) HEC missions with physician, 133 patients (7%) for analysis, pre-alpine region of Switzerland | trauma: n = 102 (77%) minor trauma: n = 14 (10%). |
medical interventions: • major analgesia with sedation: n = 4 (3%) • fracture reduction: n = 5 (4%) • intravenous fluid administration (> 1500 ml): n = 4 (3%) • endotracheal intubation: n = 5 (4%), (point of time not mentioned) |
| Sherren PB [11] | Prospective study. Review of physician only interventions in all missions involving hoisting of a physician, Australia, 2009 to 2012 |
1582 HEMS missions, 130 (8%) HEC missions with physician, 120 patients (8%) for analysis, remote and inaccessible regions of New South Wales, Australia | trauma: n = 108 (90%) | 63 physician only interventions in n = 48 (40%) patients: • advanced analgesia: 44 (70%) • advanced airway management: 5 (8%) (point of time not mentioned) • circulatory support: 3 (5%) • orthopedic manipulation of joints/limbs: 6 (10%) • thoracostomy: 1 (2%) • diagnostic ultrasound: 1 (2%) • hypertonic saline administration: 3 (5%) |
| Ausserer J [12] | Retrospective registry study. Review of trauma patients with the aim to identify victims sustaining major trauma during recreational activities in mountainous terrain, Austria 2011 to 2013 | 58 major trauma victims (Injury Severity Score ≥ 16), 40 (69%) HEC operations, in remote and mountainous areas in the State of Tyrol | head/neck trauma: n = 25 (35%) chest trauma: n = 27 (37%) | medical interventions: • ATLS before HEC operation: n = 30 (75%) • advanced airway management: n = 23 (40%) (point of time not mentioned) |
| Ney L [6] | Retrospective study. Air Zermatt database, Switzerland, 2010 to 2015 |
10,027 HEMS missions, 2808 (28%) HEC evacuations, in the high alpine regions of Switzerland | HEC evacuation and NACA-Score ≥ 4: n = 602 (21% of all HEC evacuations) | |
| Ruppert M [21] | Retrospective registry study. Review of all primarily admitted patients with and without hoist rescue, Germany, 2006 to 2015 |
20,241 HEMS missions, 1813 (9%) HEC operations, two HEMS bases in the pre-alpine regions of Germany | trauma in HEC missions: n = 850 (71%) major trauma in HEC missions: n = 127 (11%) cardiovascular diseases in HEC missions: n = 129 (11%) |
medical interventions in HEC missions: • reposition of joint or limb: n = 190 (11%) • endotracheal intubation: n = 83 (5%) (point of time not mentioned) • CPR: n = 41 (2%) • thoracostomy: n = 8 (0.4%) • intraosseous access: n = 6 (0.3%) |
| Pasquier M [4] | Retrospective study. Review of medical interventions in all missions involving hoisting of a physician, Switzerland, 2003 to 2008 | 9879 HEMS missions, 921 (9%) HEC operations, in the alpine region of Switzerland | trauma in HEC operations: n = 840 (91%) paediatric patients (≤15 years): n = 56 (6%) |
HEC operation and NACA-Score ≥ 4: n = 246 (27% of all HEC operations) medical interventions in HEC missions: • major analgesia: n = 478 (52%) • vasoactive drugs: n = 26 (2%) • endotracheal intubation: n = 16 (2%) (at the scene of accident) • intravenous fluid administration (> 1000 ml): n = 16 (2%) • CPR: n = 7 (1%) |
| Carpenter J [22] | Retrospective study. Review of patient demographics hoisted in the backcountry of Utah, USA, from 2001 to 2011 | 171 HEC missions with 214 patients | trauma in HEC missions: n = 146 (68%) | Medical interventions in HEC missions: • CPR: n = 5 (2%) |
ATLS advanced trauma life support, CPR cardiopulmonary resuscitation, HEC human external cargo, HEMS helicopter emergency medical service, NACA National Advisory Committee for Aeronautics