Aeromedical evacuation in Bosnia.

The objective of this study was to assess the value of aeromedical evacuation when compared to road ambulance transportation in predominantly trauma patients in a rural area. Uniquely, trauma was the most common presenting condition (75%), distances to secondary care facilities were long and road routes were poor with a risk of being mined. Data were collected of all British aeromedical flights in Multi-National Division Southwest, Bosnia-Herzegovina, over a six-month period, and benefit to the patient was assessed by a panel of experts when compared to calculated road ambulance evacuation. Sixty-nine patients were evacuated by air on 57 flights and transported to a secondary care facility for further management. The panel of experts found that only 15 of the 69 patients (22%) had benefited from aeromedical evacuation. This study again shows the low benefit to the patient from indiscriminate use of aeromedical evacuation, despite the air ambulance being operated in apparently ideal conditions of a high percentage of trauma, a rural setting and poor road communications. Crew safety and the high costs further highlight the need to devise a system that can screen out unnecessary flights and identify those patients who would benefit most.