a Department of Global Public Health and Primary Care , University of Bergen , Bergen , Norway.
b National Centre for Emergency Primary Health Care , Uni Research , Bergen , Norway.
Scand J Prim Health Care. 2019 Jun;37(2):233-241. doi: 10.1080/02813432.2019.1608056. Epub 2019 Apr 29.
Despite the potential benefits of physician-staffed Helicopter Emergency Medical Service (HEMS), many dispatches to primary HEMS missions in Norway are cancelled before patient encounter. Information is sparse regarding the health consequences when medically indicated HEMS missions are cancelled and the patients are treated by a GP and ambulance staff only. We aimed to estimate the potential loss of life years for patients in these situations. We included all HEMS requests in the period 2010-2013 from Sogn and Fjordane County that were medically indicated but subsequently cancelled. This provided a selection of patients, with the purpose of studying cancellations independently of the patient's medical status A multidisciplinary expert panel retrospectively assessed each patient's potential loss of life years due to the lack of helicopter transport and intervention by a HEMS physician. The study included 184 patients from 176 missions. Because of unavailable HEMS, seven patients (4%) were anticipated to have lost a total of 18 life years. Three patients suffered from myocardial infarction, three from stroke and one from abdominal haemorrhage. The main contribution from HEMS care in these seven cases might have been rapid transport to definitive care. The probability of a patient losing life years when in need of HEMS evacuation was found to be 0.2%. During the four years period seven patients lost 18 life years. Lack of rapid transport seems to be the primary cause of lost life years in this specific geographical area. Key Points Knowledge about to what extent HEMS contributes to an increased survival and a better outcome for patients is limited. Compared to similar studies on life years gained the estimated loss of life years was minor when HEMS evacuation was unavailable in this rural area. The findings indicates that lack of rapid HEMS transport was the primary cause of the estimated loss of life years.
尽管配备医生的直升机紧急医疗服务（HEMS）具有潜在益处，但在挪威，许多原发性 HEMS 任务的派遣在患者接触之前就被取消了。当出于医疗原因取消 HEMS 任务且仅由全科医生和救护车工作人员进行治疗时，有关健康后果的信息很少。我们旨在估计这些情况下患者潜在的生命损失年数。我们纳入了 2010 年至 2013 年来自松恩和菲尤拉讷郡的所有 HEMS 请求，这些请求在医学上是合理的，但随后被取消。这为患者提供了选择，目的是独立于患者的医疗状况研究取消情况。一个多学科专家小组回顾性评估了每个患者由于缺乏直升机运输和 HEMS 医生的干预而潜在的生命损失年数。该研究包括 176 次任务中的 184 名患者。由于无法使用 HEMS，预计有 7 名患者（4%）总共会失去 18 个生命年。其中 3 名患有心肌梗塞，3 名患有中风，1 名患有腹部出血。在这 7 例患者中，HEMS 护理的主要贡献可能是快速转运至确定性治疗。当需要 HEMS 疏散时，患者失去生命年的概率被发现为 0.2%。在四年期间，有 7 名患者失去了 18 个生命年。在这个特定的地理区域，缺乏快速转运似乎是失去生命年的主要原因。要点 HEMS 对增加患者生存率和改善预后的贡献程度知之甚少。与类似的生命年获得研究相比，在这个农村地区当无法进行 HEMS 疏散时，估计的生命损失年数较小。研究结果表明，缺乏快速 HEMS 转运是估计生命损失年数的主要原因。
