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1999

Air ambulance tasking: why and how?

03 June 2011
Volume 3 · Issue 6

Abstract

Air ambulances are a scarce and expensive resource and their use carries significant risk for crew and patients (Hennesy; 2005; Holland et al. 2005; Hinkelbein et al, 2008; Lutman et al, 2008). To benefit appropriate patients while minimizing risk and cost, tasking of air ambulance assets should ideally be sensitive and specific. Within the UK and across Europe, there are no standardized criteria to dispatch these resources (Littlewood et al, 2010; Wigman et al, 2010). Even where dispatch criteria are agreed, compliance is variable (Tiamfook-Morgan et al, 2008). The purpose of this review is to look at the evidence and rationale for tasking of air ambulance assets.

There are many models of air ambulance service delivery worldwide. Due to the vast differences in service delivery, operational scope, staffing, clinical competencies and geography, direct comparison can be difficult. Within the literature around air ambulance use, the number of prospective randomized studies is small but increasing with a large amount of observational data available. Notwithstanding these caveats, there is significant information available in the scientific literature and recurrent themes are evident.

Air ambulance services are delivered using both fixed wing and rotary aircraft. Helicopter (rotary wing) air ambulances are often high profile prehospital emergency medical resources carrying out primary response, often incorporating search and rescue capability as well as secondary transport and retrieval (Figure 1). Within some services, helicopter air ambulances are also used for non–emergency transport and repatriation also.

Fixed wing air ambulance resources usually carry out secondary retrieval, interhospital transfer and repatriation, often across larger distances. Fixed wing ambulances are also used to deliver primary care and public health in large landmasses such as Australia. Primary responses are more challenging for fixed wing aircraft due to the need for a suitable landing strip, but this is not unheard of in Australia.

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