Volume 17 Supplement 3

Scandinavian Update on Trauma, Resuscitation and Emergency Medicine 2009

Open Access

Air ambulance missions to patients at locations not accessible by road – pleasant way to evacuate or advanced medicine in the field?

  • Andreas J Krüger1, 2 and
  • Sindre Mellesmo1, 2
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine200917(Suppl 3):O28

https://doi.org/10.1186/1757-7241-17-S3-O28

Published: 28 August 2009

Introduction

The air ambulance system in Norway is supposed to assist the critical ill or injured patient outside hospital. Indication for dispatch is urgent need for medical treatment or significant benefit in transport times to definitive care.

This service is also used for evacuation of patients at locations not accessible by road, and the indication for this practice has been debated.

In the current study we sought to investigate missions to patients at such locations.

Methods

Retrospective analysis of data from Dombås HEMS base in the period 1999–2008.

Patient characteristics, operational details and data on medical interventions were assessed and compared between the two sub-populations: those located at areas not accessible by road and those who were located at accessible sites. Chi-square and Mann-Whitney tests were used for statistical analysis for categorical and continuous data respectively.

Results

3659 missions were included in the analysis. Of these, 606 missions were to locations not accessible by road. Results are presented in the Tables 1 and 2 below:
Table 1

Patient and operational characteristics:

Accessible by road

Yes

No

P-value for difference

Characteristic

   

Age (mean, 95% CI)

46,6 (45.5-47.6)

45,2 (43.7-46.8)

0,15

Gender (% males)

63,5

58,7

0,03

Unit hour (median, range)

1:28 (0:05–7:57)

1:13 (0:10–12:25)

0,96

On Scene Time (median, range)

0:19 (0:00–3:12)

0:15 (0:00–7:50)

<0,001

NACA (median IQR)

4 (2–6)

3(2–4)

<0,001

Summer

78%

22%

<0,001

Winter

89%

11%

 

Anasthesia

10,7%

10,4%

0,88

Table 2

Preliminary diagnosis:

 

Accessible by road

Not accessible by road

Trauma

40%

62%

Cardiac

30%

13%

Muscular/skeletal

0%

4%

Endocrine

1%

1%

Nervous system

3%

1%

GI

3%

1%

Unclassified

10%

10%

Conclusion

Patients located at non-accessible scenes are more often injured and female compared to our standard patient population. Median mission duration was shorter, but can occasionally very time-consuming. The fraction of patients receiving general anesthetics is the same in both groups, indicating the need for the anesthetist on-scene for a significant number of missions.

We conclude that our current practice of dispatch seems appropriate, but further studies on injury profile among patients located at places not accessible by road should be done.

Authors’ Affiliations

(1)
Norwegian Air Ambulance Foundation
(2)
Dep. Of Anaesthesiology and Acute Care, St. Olavs Hospital

Copyright

© Krüger and Mellesmo; licensee BioMed Central Ltd. 2009

This article is published under license to BioMed Central Ltd.

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