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Table 2 Characteristics of patients and medical interventions in human external cargo missions

From: Advanced airway management in hoist and longline operations in mountain HEMS – considerations in austere environments: a narrative review This review is endorsed by the International Commission for Mountain Emergency Medicine (ICAR MEDCOM)

Study Study design Setting Patients Findings
Corniche J [10] Prospective study. Review of primary rescue interventions in all missions involving hoisting of a physician, Switzerland, 1998 to 2002 1855 HEMS missions, 156 (8%) HEC missions with physician, 133 patients (7%) for analysis, pre-alpine region of Switzerland trauma: n = 102 (77%) minor trauma: n = 14 (10%). medical interventions: • major analgesia with sedation: n = 4 (3%) • fracture reduction: n = 5 (4%) • intravenous fluid administration (> 1500 ml): n = 4 (3%) • endotracheal intubation: n = 5 (4%), (point of time not mentioned)
Sherren PB [11] Prospective study. Review of physician only interventions in all missions involving hoisting of a physician, Australia, 2009 to 2012 1582 HEMS missions, 130 (8%) HEC missions with physician, 120 patients (8%) for analysis, remote and inaccessible regions of New South Wales, Australia trauma: n = 108 (90%) 63 physician only interventions in n = 48 (40%) patients: • advanced analgesia: 44 (70%) • advanced airway management: 5 (8%) (point of time not mentioned) • circulatory support: 3 (5%) • orthopedic manipulation of joints/limbs: 6 (10%) • thoracostomy: 1 (2%) • diagnostic ultrasound: 1 (2%) • hypertonic saline administration: 3 (5%)
Ausserer J [12] Retrospective registry study. Review of trauma patients with the aim to identify victims sustaining major trauma during recreational activities in mountainous terrain, Austria 2011 to 2013 58 major trauma victims (Injury Severity Score ≥ 16), 40 (69%) HEC operations, in remote and mountainous areas in the State of Tyrol head/neck trauma: n = 25 (35%) chest trauma: n = 27 (37%) medical interventions: • ATLS before HEC operation: n = 30 (75%) • advanced airway management: n = 23 (40%) (point of time not mentioned)
Ney L [6] Retrospective study. Air Zermatt database, Switzerland, 2010 to 2015 10,027 HEMS missions, 2808 (28%) HEC evacuations, in the high alpine regions of Switzerland   HEC evacuation and NACA-Score ≥ 4: n = 602 (21% of all HEC evacuations)
Ruppert M [21] Retrospective registry study. Review of all primarily admitted patients with and without hoist rescue, Germany, 2006 to 2015 20,241 HEMS missions, 1813 (9%) HEC operations, two HEMS bases in the pre-alpine regions of Germany trauma in HEC missions: n = 850 (71%) major trauma in HEC missions: n = 127 (11%) cardiovascular diseases in HEC missions: n = 129 (11%) medical interventions in HEC missions: • reposition of joint or limb: n = 190 (11%) • endotracheal intubation: n = 83 (5%) (point of time not mentioned) • CPR: n = 41 (2%) • thoracostomy: n = 8 (0.4%) • intraosseous access: n = 6 (0.3%)
Pasquier M [4] Retrospective study. Review of medical interventions in all missions involving hoisting of a physician, Switzerland, 2003 to 2008 9879 HEMS missions, 921 (9%) HEC operations, in the alpine region of Switzerland trauma in HEC operations: n = 840 (91%) paediatric patients (≤15 years): n = 56 (6%) HEC operation and NACA-Score ≥ 4: n = 246 (27% of all HEC operations) medical interventions in HEC missions: • major analgesia: n = 478 (52%) • vasoactive drugs: n = 26 (2%) • endotracheal intubation: n = 16 (2%) (at the scene of accident) • intravenous fluid administration (> 1000 ml): n = 16 (2%) • CPR: n = 7 (1%)
Carpenter J [22] Retrospective study. Review of patient demographics hoisted in the backcountry of Utah, USA, from 2001 to 2011 171 HEC missions with 214 patients trauma in HEC missions: n = 146 (68%) Medical interventions in HEC missions: • CPR: n = 5 (2%)
  1. ATLS advanced trauma life support, CPR cardiopulmonary resuscitation, HEC human external cargo, HEMS helicopter emergency medical service, NACA National Advisory Committee for Aeronautics