| Summary: | A research report submitted to the Faculty of Health Sciences, University of
Witwatersrand, Johannesburg, in Partial fulfilment for the Master of Medicine
(Emergency Medicine)
Johannesburg, 2016. === Background: Helicopter Emergency Medical Services (HEMS) are a specialized flying
emergency service providing in-flight specialized care. There is a paucity of data on the use
of HEMS in South Africa.
Objective: To describe demographics and clinical characteristics of patients transported with
HEMS and the indications for HEMS dispatches. Medical crew configuration, clinical
procedures undertaken by the HEMS crew, time frames from HEMS dispatch to delivery of
patient to the receiving hospital and flight patterns were analyzed.
Methods: A retrospective medical chart review of flights conducted over the calendar year
2013 by a private HEMS based in Gauteng province, South Africa.
Results: A total of 199 flights were reviewed. The most common reason for transport was
trauma (70%). Primary transfers constituted 62% of all flights undertaken and 93% were due
to trauma. For inter-hospital transfers, the most common reason for transport was cardiac
emergencies (40%). Transfer to specialist care was the most common indication for transport.
Advanced life support paramedics performed 99% of HEMS transfers. The most common
procedures done by HEMS crews were sedation and pain control followed by intravenous
access.
Conclusions: There is a high incidence of primary transfers in this study, mainly due to
trauma. Further research should focus on optimal flight activation criteria for HEMS use
within a resource constrained setting to optimize the potential benefits. HEMS crew need
continuous professional training to maintain knowledge and skills. Incorporation of finger
thoracostomy in required skills for advanced life support paramedics should be considered. === LG2018
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