Heinrich Sebastian, Wielant Christoph, Lerch Frank, Friedrich Mirko, Braun Jörg, Reifferscheid Florian, Busch Hans-Jörg
Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
German Air Rescue, DRF Stiftung Luftrettung Gemeinnützige AG, Rita-Maiburg-Str. 2, 70794, Filderstadt, Germany.
Scand J Trauma Resusc Emerg Med. 2024 Dec 2;32(1):122. doi: 10.1186/s13049-024-01297-9.
Helicopter hoist operations (HHO) are an important option for rescue operations in rugged and challenging terrain. German mid-range mountains are characterized by the versatility of ground conditions, few urban structures, and frequent use for local leisure activities, including the practice of more or less high-risk outdoor sports. This retrospective analysis aims to investigate the incidence of rescue missions in German mid-range mountains requiring HHO. The contributing air rescue bases' operational tactics and the underlying medical characteristics, such as injury patterns and the provided medical care, are also reported.
This study is a retrospective analysis of the documentation of HHO missions carried out at the air rescue bases in Freiburg, Nuremberg, and Bautzen staffed by emergency physicians between 01/2020 and 07/2022. Data was extracted from the German Air Rescue database. To assess the topics of interest, we conducted basic descriptive statistics.
Data selection retrieved 410 HHO-associated rescue missions. A total of 304 datasets, including HHO, were suitable for further statistical processing. Air rescue base Freiburg contributed 152, Nuremberg 63, and Bautzen 89 missions. HHO missions showed an increased frequency in the summer season and from Friday to Sunday. In this collective, 75% of the underlying diagnoses were trauma-associated; in 33% of all patients, traumatic injury of the pelvis or lower limb occurred. 28% of the patients were in a potential or actual life-threatening condition and were scored NACA 4 or higher. The rates of invasive medical treatment, such as endotracheal intubation (5%) or venous access (79%), were considerably higher than in overall emergency missions. In terms of mission tactics and cooperation with mountain rescue services, different approaches of the three air bases resulted in differences regarding first-on-scene rates and time spans.
The results show a relevant year-round need to deploy emergency medical expertise to inaccessible terrain in the three regions examined. Detailed analysis showed relevant differences in operational tactics between the three bases and potential for optimization. Simultaneous alerting of the hoist helicopter and reliable and precise coordination with other rescue organizations involved, especially the local mountain rescue service and the rescue coordination center, can help to shorten both the treatment-free interval and the prehospital time for patients in inaccessible terrain.
The study is registered at DRKS (DRKS00033493).
直升机吊运作业（HHO）是在崎岖且具有挑战性的地形中进行救援行动的重要选择。德国中部山区的特点是地面条件多样、城市建筑较少，且经常用于当地休闲活动，包括或多或少具有高风险的户外运动。这项回顾性分析旨在调查德国中部山区需要直升机吊运作业的救援任务发生率。还报告了参与救援的空中救援基地的作战策略以及潜在的医疗特征，如损伤模式和所提供的医疗护理。
本研究是对2020年1月至2022年7月期间由急诊医生在弗赖堡、纽伦堡和包岑的空中救援基地执行的直升机吊运作业任务记录进行的回顾性分析。数据从德国空中救援数据库中提取。为评估感兴趣的主题，我们进行了基本的描述性统计。
数据筛选得到410次与直升机吊运作业相关的救援任务。总共304个数据集，包括直升机吊运作业，适合进一步的统计处理。弗赖堡空中救援基地贡献了152次任务，纽伦堡63次，包岑89次。直升机吊运作业任务在夏季以及周五至周日的频率有所增加。在这个总体中，75%的潜在诊断与创伤相关；在所有患者中，33%发生了骨盆或下肢创伤性损伤。28%的患者处于潜在或实际危及生命的状况，NACA评分为4分或更高。侵入性医疗治疗的比率，如气管插管（5%）或静脉通路建立（79%），明显高于总体急诊任务。在任务策略以及与山地救援服务的合作方面，三个空中救援基地的不同方法导致了现场救援率和时间跨度的差异。
结果表明，在所研究的三个地区，全年都有必要向难以到达的地形部署紧急医疗专业人员。详细分析表明，三个基地在作战策略上存在显著差异，且有优化的潜力。同时提醒吊运直升机，并与其他相关救援组织，特别是当地山地救援服务和救援协调中心进行可靠而精确的协调，有助于缩短难以到达地形中患者的无治疗间隔时间和院前时间。
该研究已在DRKS注册（DRKS00033493）。
