Abstract
BackgroundPhysician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care. This paper describes the integration of such a system in a rural Swedish county.MethodsThis is a retrospective database study recording the outcomes of every emergency call centre dispatch request as well as the clinical and operational data from all completed missions during this service’s first year in operation.ResultsDuring the study period, HEMS completed 478 missions out of which 405 (84,7%) were primary missions to prehospital settings and 73 (15,3%) were inter-hospital critical care transfers. A majority (55,3%) of primary missions occurred in the regions furthest from our hospitals, in municipalities housing only 15,6% of the county’s population. The NACA (IQR) score on primary and secondary missions was 4 (2) and 5 (1), respectively.ConclusionsThis study describes the successful integration of a physician-based air ambulance service in a Scandinavian rural region. Municipalities distant from our hospitals benefitted as they now have access to early specialist intervention and expedient transport to critical hospital care. Our hospitals and most populated areas benefitted from HEMS secondary mission capability as they gained a dedicated ICU transport service that could provide specialist intensive care during rapid inter-hospital transfer.
Highlights
Physician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care
Dalarna helicopter emergency service The service employs an Airbus H-145 helicopter platform and operates as a 24-h service with a crew consisting of one pilot, one HEMS crewmember (HCM) and one physician
While the helicopter remains the primary mode of dispatch, a rapid response car (RRC) is available at the hangar facilities
Summary
Physician-staffed helicopter emergency services (HEMS) can provide benefit through the delivery of specialist competence and equipment to the prehospital scene and through expedient transport of critically ill patients to specialist care. This paper describes the integration of such a system in a rural Swedish county. Dalarna is a mixed urban and rural county located in central Sweden. The region has an inland subarctic climate with cool summers and long, often cold, winters. The county has a population of 285,000 inhabitants, covers an area of 28,000 square km and is divided into 15 municipalities (Fig. 1). Lakes and rivers are prominent features in the middle, southern and eastern parts, along which the major population centres are located. Dalarna mostly consists of vast forest areas where logging is a dominant industry. The western-most part lies within the Scandinavian mountain ranges. This alpine region houses many of Northern Europe’s most visited ski-resorts. The county annually welcomes more than 2,000,000 tourists
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