References
Prehospital anaesthesia by a helicopter emergency medicine service: a review
Abstract
Background:
The Northern Ireland (NI) Ambulance Service launched its helicopter emergency medical service (HEMS) in 2017.
Aims:
This paper reviews the first 200 cases of prehospital emergency anaesthesia (PHEA).
Methods:
A retrospective review of the NI HEMS intubation database between 29 July 2017 and 28 February 2021 was conducted.
Findings:
PHEA was delivered as rapid sequence intubation (RSI). There was a 100% RSI success rate. The mean 999 call to RSI time was 65.9 minutes (median=61 minutes), with 14.6% of procedures carried out within the National Institute for Health and Care Excellence target of 45 minutes or less. The first pass oral intubation rate was 89.3%. There was a significant difference in the number of male compared to female patients (men=145; women=55;
Conclusion:
PHEA delivery by the HEMS since it was set up has been successful provided in a safe, robust manner. Reducing the 999 call to RSI time in line with the National Institute for Health and Care Excellence target was identified as an area for development.
The Northern Ireland (NI) Ambulance Service began operating a helicopter emergency medical service (HEMS) in July 2017 and has provided the region with a single, helicopter-based prehospital care team since. The running of NI HEMS is supported by the work of publicly funded charity Air Ambulance Northern Ireland. NI HEMS operates in daylight hours, 7 days a week and responds to emergencies either by helicopter (Helimed 23) or via a ground-based rapid response vehicle (rapid response vehicle Delta-7) as appropriate. Care is delivered by a two-person team composed of a paramedic and a consultant physician. The service operates alongside ground-based ambulance crews and other emergency services covering the whole of NI, which has a population of approximately 1.9 million (Northern Ireland Statistics and Research Agency, 2021). Figure 1 shows approximate flight durations and distances across the region.
The delivery of patients via Helimed-23 to the regional major trauma centre at the Royal Victoria Hospital emergency department (RVH-ED) has changed since the NI HEMS became operational. Initially established as a trauma-focused service, it has now evolved into a prehospital emergency medical service.
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