S Afr Med J. 2014 Feb;104(2):124-6. doi: 10.7196/samj.7310.
A helicopter emergency medical service (HEMS) was established in 2005 in Richards Bay, KwaZulu-Natal, South Africa, to provide primary response and inter-facility transfers to a largely rural area with a population of 3.4 million people.
To describe the first 5 years of operation of the HEMS.
A chart review of all flights from 1 January 2006 to 31 December 2010 was conducted.
A total of 1 429 flights were undertaken; 3 were excluded from analysis (missing folders). Most flights (88.4%) were inter-facility transfers (IFTs). Almost 10% were cancelled after takeoff. The breakdown by age was 61.9% adult, 15.1% paediatric and 21.6% neonate. The main indications for IFTs were obstetrics (34.5%), paediatrics (27.9%) and trauma (15.9%). For primary response most cases were trauma (72.9%) and obstetrics (11.3%). The median on-scene time for neonates was significantly longer (48 min, interquartile range (IQR) 35 - 64 min) than that for adults (36 min, IQR 26 - 48; p < 0.001) and paediatrics (36 min, IQR 25 - 51; p < 0.02). On-scene times for doctor-paramedic crews (45 min, IQR 27 - 50) were significantly longer than for paramedic-only crews (38 min, IQR 27 - 57; p < 0.001).
The low flight-to-population ratio and primary response rate may indicate under-utilisation of the air medical service in an area with a shortage of advanced life support crews and long transport distances. Further studies on HEMSs in rural Africa are needed, particularly with regard to cost-benefit analyses, optimal activation criteria and triage systems.
2005 年，在南非夸祖鲁-纳塔尔省的理查兹湾建立了直升机紧急医疗服务（HEMS），为拥有 340 万人口的广大农村地区提供初步响应和医院间转院服务。
描述 HEMS 运行的头 5 年。
对 2006 年 1 月 1 日至 2010 年 12 月 31 日期间的所有飞行进行图表回顾。
共进行了 1429 次飞行；其中 3 次因文件夹缺失而被排除在分析之外。大多数飞行（88.4%）是医院间转院（IFT）。起飞后几乎有 10%的飞行被取消。按年龄划分，成人占 61.9%，儿科占 15.1%，新生儿占 21.6%。IFT 的主要指征是产科（34.5%）、儿科（27.9%）和创伤（15.9%）。对于初步响应，大多数病例是创伤（72.9%）和产科（11.3%）。新生儿的现场中位数时间明显长于成人（48 分钟，四分位距[IQR] 35-64 分钟）和儿科（36 分钟，IQR 25-51；p<0.001）。医生-护理人员机组（45 分钟，IQR 27-50）的现场时间明显长于仅护理人员机组（38 分钟，IQR 27-57；p<0.001）。
低飞行与人口比和初步响应率可能表明，在一个缺乏高级生命支持人员和长距离转运的地区，空中医疗服务利用不足。需要对非洲农村地区的 HEMS 进行进一步研究，特别是关于成本效益分析、最佳激活标准和分诊系统。
