Medical Directorate, National Ambulance Service, Dooradoyle House, Dooradoyle Road, Limerick, V94 HW6E, Ireland.
Emergency Department, Cork University Hospital, Cork, Ireland.
Scand J Trauma Resusc Emerg Med. 2020 Apr 16;28(1):28. doi: 10.1186/s13049-020-00722-z.
Patients served by Helicopter Emergency Medical Services (HEMS) tend to be acutely injured or unwell and in need of stabilisation followed by rapid and safe transport. It is therefore hypothesised that a particular clinical crew composition is required to provide appropriate HEMS patient care. A literature review was performed to test this hypothesis.
MEDLINE, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews were systematically searched from 1 January 2009 to 30 August 2019 to identify peer-reviewed articles of relevance. All HEMS studies that mentioned 'staffing', 'configuration', 'competencies' or 'qualifications' in the title or abstract were selected for full-text review.
Four hundred one studies were identified. Thirty-eight studies, including one systematic review and one randomised controlled trial, were included. All remaining studies were of an observational design. The vast majority of studies described clinical crews that were primarily doctor-staffed. Descriptions of non-doctor staff competencies were limited, with the exception of one paramedic-staffed model.
HEMS clinical crews tended to have a wider range of competencies and experience than ground-based crews, and most studies suggested a patient outcome benefit to HEMS provision. The conclusions that can be drawn are limited due to study quality and the possibility that the literature reviewed was weighted towards particular crewing models (i.e. primarily doctor-staffed) and countries. There is a need for trial-based studies that directly compare patient outcomes between different HEMS crews with different competencies and qualifications.
直升机紧急医疗服务（HEMS）所服务的患者往往伤势严重或身体不适，需要稳定病情，然后快速、安全地转运。因此，有人假设需要特定的临床机组人员配置来提供适当的 HEMS 患者护理。进行了文献回顾以检验这一假设。
从 2009 年 1 月 1 日至 2019 年 8 月 30 日，系统地检索了 MEDLINE、EMBASE、Web of Science 和 Cochrane 系统评价数据库，以确定相关的同行评审文章。选择标题或摘要中提及“人员配备”、“配置”、“能力”或“资格”的所有 HEMS 研究进行全文审查。
确定了 401 项研究。纳入了 38 项研究，包括 1 项系统评价和 1 项随机对照试验。其余所有研究均为观察性设计。绝大多数研究描述了主要由医生配备的临床机组。除了一个配备护理人员的模型外，非医生人员能力的描述有限。
HEMS 临床机组人员的能力和经验范围往往比地面机组人员更广，大多数研究表明 HEMS 服务对患者预后有益。由于研究质量和所审查的文献可能偏向特定的机组人员配置（即主要由医生配备）和国家，因此可以得出的结论有限。需要进行基于试验的研究，直接比较具有不同能力和资格的不同 HEMS 机组人员的患者预后。
