New order of things: An international overview of air medical transport

Abstract

To give an impression of where the development of helicopter EMS (HEMS) may lead in the future, we first need to look back at where we came from. With the use of fixed-wing aircraft in World War II, the first ideas about how to evacuate victims from the battlegrounds were tested. But the technical limitations of the systems prohibited large-scale use at that time. In the Korean War, an estimated 100,000 casualties were airlifted by helicopter; in Vietnam, only 10 years later, the Bell Huey made approximately 1 million transports and became a crucial instrument for transport and helicopter rescue. Admittedly, only the military had access to this form of trauma care, which was merely a form of fast transport from remote areas. On-scene medical treatment was-and had to be-confined to a minimum. Inspired by these wartime experiences and considered in the context of an increasing incidence of motor vehicle crashes, the need for civilian prehospital care was addressed on an international scale with ground-based rescue. Although the “emergency doctor service” worked quite well in major cities, accidents in suburban and rural areas still presented problems because of large service areas and long response intervals in heavy traffic during rush hours and holiday seasons. The countryside continued to be a virtual ground EMS wasteland-response times of 30, 40, or more minutes were normal. In rural and remote, mountainous, or coastal areas, the helicopter therefore became and continues to be the transport system of choice. In these regions, the HEMS system offers a faster means of medical assistance with a significantly larger action range, coupled with the ability to transport the patient directly to the appropriate specialized medical center.