HEMS inter-facility transfer: a case-mix analysis

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Serval ID
serval:BIB_D79AA61495D7
Type
A Master's thesis.
Publication sub-type
Master (thesis) (master)
Collection
Publications
Institution
Title
HEMS inter-facility transfer: a case-mix analysis
Author(s)
DI ROCCO D.
Director(s)
DAMI F.
Codirector(s)
CARRON P.-N.
Institution details
Université de Lausanne, Faculté de biologie et médecine
Publication state
Accepted
Issued date
2017
Language
english
Number of pages
25
Abstract
Background
Helicopter emergency medical services (HEMS) are popular rescue systems despite
inconsistent evidence in the scientific literature to support their use. There is little research
about inter-facility transfer (IFT) by HEMS, hence questions remain about the
appropriateness of this method of transport. The aim of this study is to describe a case-mix’s
operational and medical characteristics for IFT activity of a sole HEMS base.
Methods
This is a retrospective study on HEMS IFT over 36 months, from January 1st, 2013 to
December 31st 2015. Medical and operational data from the database of the Emergency
Department of Lausanne University Hospital which provides the emergency physicians for
this helicopter base were reviewed. It included time of transport compared to ground
transport and type of care during flight.
Results
There were 2194 HEMS missions including 979 IFT (44.6%). Most transfers involved adults
(> 17 years old) (799 patients, 81.6%). Forty patients (4.1% of total) were classified as
having benefitted from resuscitation or life-saving measures performed in flight, 615 (62.8%)
from an emergency treatment and 324 (33.1%) from a simple clinical examination. The
overall mean distance by air in-between hospitals was 39.1 km (median 35.4 km). The
overall mean distance by road was 56.0 km (median 47.7 km). The overall mean duration
time from origin to destination by air was 14 min (median 12 min); by road it was 43 min
(median 36 min).
Conclusions
A third of patients did not receive any treatment during flight, some other a continuous
perfusion which itself may have motivated the activation of HEMS, and the median distance
of travel of our case mix was <50 km. Although not all those HEMS missions can be
classified as inappropriate, each system based on its own specificity needs to developed
criteria to reduce overtriage
Keywords
Inter-facility transfer (IFT), helicopter emergency medical services (HEMS), case-mix
Create date
05/09/2018 13:10
Last modification date
08/09/2020 6:11
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