Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland

摘要

We aimed to investigate the medical characteristics of helicopter hoist operations (HHO) in HEMS missions. We designed a retrospective study evaluating all HHO and other human external cargo (HEC) missions performed by Swiss Air-Rescue (Rega) between January 1, 2010, and December 31, 2019. During the study period, 9,963 (88.7?%) HEMS missions with HHO and HEC were conducted during the day, and 1,265 (11.3?%) at night. Of the victims with time-critical injuries (NACA?≥?4), 21.1?% (n?=?400) reached the hospital within 60?min during the day, and 9.1?% (n?=?18) at night. Nighttime missions, a trauma diagnosis, intubation on-site, and NACA Score?≥?4 were independently and highly significantly associated with longer mission times (p??0.001). The greatest proportion of patients who needed hoist or HEC operations in the course of the HEMS mission during the daytime sustained moderate injuries (NACA 3, n?=?3,731, 37.5?%) while practicing recreational activities (n?=?5,492, 55.1?%). In daytime HHO missions, the most common medical interventions performed were insertion of a peripheral intravenous access (n?=?3,857, 38.7?%) and administration of analgesia (n?=?3,121, 31.3?%). Nearly 20?% of patients who needed to be evacuated by a hoist were severely injured, and complex and lifesaving medical interventions were necessary before the HHO procedure. Therefore, only adequately trained and experienced medical crew members should accompany HHO missions.