A prospective survey of critical care procedures performed by physicians in helicopter emergency medical service: is clinical exposure enough to stay proficient?

Table 1 Procedures expected to be performed by a prehospital physician at least once a year. The average number of procedures is based on 61 24-h shifts (All, OUH HEMS and SUH HEMS) or 42 24 h shifts (Rygge SAR) per year. Numbers apply for all age groups if nothing else is noted

		OUH HEMS	SUH HEMS	Rygge SAR
BMV in patient	1–12 yoa	0.4	1.5	0.2
BMV in patient	>12 yoa	7.5	26.6	1.8
ETI in patient	<1 yoa, all categories	1.1	0.0	0.2
	1–12 yoa, all categories	1.3	1.0	0.2
	>12 yoa, other	5.2	6.3	0.0
	>12 yoa, respiratory distress	1.3	1.2	0.0
	>12 yoa, cardiac arrest	7.8	16.3	2.5
	>12 yoa, trauma	5.0	3.9	0.8
Inhalation therapy		1.4	1.0	0.3
Invasive ventilator in patient	<1 yoa	2.0	0.0	0.0
	1–12 yoa	2.3	0.0	0.0
	>12 yoa	36.1	9.3	1.3
Non-invasive ventilator in patient >12 yoa		2.7	1.0	0.3
ACLS in patient >12 yoa		13.8	23.4	3.2
Anti arrhythmic therapy		2.4	1.0	0.3
Vasopressor initiated		5.6	1.7	0.5
Vasopressor continued		12.0	3.2	0.0
Peripheral venous access in patient	<1 yoa	1.4	0.2	0.3
	1–12 yoa	3.9	2.7	0.3
	>12 yoa	30.4	44.1	5.1
Intra-osseous access in patient >12 yoa		1.6	3.9	0.3
Central venous catheter insertion		3.6	0.2	0.0
Arterial line insertion		8.8	1.2	0.5
Incubator transport	without ventilator	1.7	0.2	0.0
	with CPAP	2.2	0.0	0.0
	with ventilator support	2.9	0.0	0.0
Anaesthesia induction		25.3	11.0	1.5
Fracture repositioned		2.0	3.7	0.3
Dislocated joint repositioned		0.1	1.2	0.0
Pain management		8.8	9.3	1.7
Chest drainage		1.7	1.2	0.0
Gastric tube insertion		4.3	4.1	0.3

ACLS Advanced Cardiac Life Support, BMV Bag Mask Ventilation, CPAP Continuous Positive Airway Pressure, ETI Endotracheal Intubation, OUH HEMS Oslo University Hospital Helicopter Emergency Service, Rygge SAR Search and Rescue helicopter at Rygge, SUH HEMS Stavanger University Hospital Helicopter Emergency Service, yoa years of age