Abstract
BackgroundTo determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. Incidence and success rate of several procedures were studied, with a distinction made between procedures restricted to the HEMS-physician and procedures for which the HEMS is more experienced than the EMS.MethodsProspective study of a consecutive group of children examined and treated by the HEMS of the eastern region of the Netherlands. Data regarding type of emergency, physiological parameters, NACA scores, treatment, and 24-hour survival were collected and subsequently analysed.ResultsOf the 558 children examined and treated by the HEMS on scene, 79% had a NACA score of IV-VII. 65% of the children had one or more advanced life support procedures restricted to the HEMS and 78% of the children had one or more procedures for which the HEMS is more experienced than the EMS. The HEMS intubated 38% of all children, and 23% of the children intubated and ventilated by the EMS needed emergency correction because of potentially lethal complications. The HEMS provided the greater part of intraosseous access, as the EMS paramedics almost exclusively reserved this procedure for children in cardiopulmonary resuscitation. The EMS provided pain management only to children older than four years of age, but a larger group was in need of analgesia upon arrival of the HEMS, and was subsequently treated by the HEMS.ConclusionsThe Helicopter Emergency Medical Service of the eastern region of the Netherlands brings essential medical expertise in the field not provided by the emergency medical service. The Emergency Medical Service does not provide a significant quantity of procedures obviously needed by the paediatric patient.
Highlights
To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children
Advanced Life Support (ALS) for the pre-clinical management of vitally compromised children consists of endotracheal intubation and ventilation, intravenous or intra-osseous access with fluid replacement and administration of medication
The objective of this study was to evaluate the advanced medical interventions performed by the EMS and the HEMS in vitally compromised children, and to examine how often the HEMS provided additional medical care which was not or could not be provided by the EMS
Summary
To determine the advanced life support procedures provided by an Emergency Medical Service (EMS) and a Helicopter Emergency Medical Service (HEMS) for vitally compromised children. The purpose of on-site advanced interventions is to stabilise the patient before transport to the hospital These procedures are expected to reduce physiological deterioration, and to reduce mortality. The Helicopter Emergency Medical Service (HEMS) was introduced in the Netherlands to provide optimal pre-clinical care for trauma patients by the Dutch government. The objective of this study was to evaluate the advanced medical interventions performed by the EMS and the HEMS in vitally compromised children, and to examine how often the HEMS provided additional medical care which was not or could not be provided by the EMS
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