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Table 1 Comparison of HEMS Clinical Crew Staffing Models and Qualifications

From: What clinical crew competencies and qualifications are required for helicopter emergency medical services? A review of the literature

Country/HEMS nameStaffing ModelHEMS-Specific Qualifications/Experience
Germany
(Eich et al., 2009)
Ambulance–based emergency physician• Extensive experience in a doctor-staffed ambulance (attended at least 300 incidents as ambulance-based emergency physician)
• Hold an Advanced Life Saving Certificate
• Completed a 4-month rotation in paediatric anaesthesia
The Netherlands
(Gerritse et al., 2010)
Anaesthesiologist or trauma surgeon staffed and specialised nurse• Board certified trauma surgeon or anaesthesiologist with 6 months’ extra training in adult and paediatric emergency care, pain management and extrication technique
• Nurse training not described
Norway
(Bjornsen et al., 2018)
Doctor-staffed by anaesthetic flight physicians• Board certification in anaesthesiology
• Experience in paediatric anaesthesiology
• Completed a course in trauma care
• Have knowledge and proficiency in CPR
Great Western Air Ambulance Service, United Kingdom
(Von Vopelius-Feldt, 2014)
Prehospital critical care consultant and critical care paramedic for “80% of shifts”• Doctors undertake a training programme with “specific competencies and mentored practice, coupled with theoretical and simulation training”
• Critical care paramedics “completed a university-based theory and practical training course with mentoring and supervised experience, followed by the successful completion of a comprehensive qualifying assessment.”
Warwickshire and Northamptonshire Air Ambulance, United Kingdom (Fullerton, 2009)2 crew mixes: doctor and paramedic OR paramedic-paramedic. Dependant on staff availability• Paramedic crew undergo 40 h’ additional clinical training
• Doctors comply with eligibility requirements, including at least registrar level training and extensive training & exposure to acutely ill patients
Bristol
Great Western Air Ambulance and Wiltshire Air Ambulance, United Kingdom (Von Vopelius-Feldt, 2014)
2 crew mixes:
doctor and paramedic OR paramedic-paramedic. Dependant on staff availability
• Senior registrar or consultant in emergency medicine or anaesthesia
• Critical care paramedic with over 5 years’ experience and postgraduate certificate in pre-hospital critical care
Midlands Air Ambulance, United Kingdom (McQueen, 2015)• Doctor-staffed for high severity trauma
• Paramedic-staffed for support of ambulance crews when doctor unavailable or call would not benefit from doctor intervention
• Paramedics “have received additional training and operate as critical care paramedics.”
• Doctor is senior trainee in emergency medicine, critical care or anaesthesia and has undergone specialist training to deliver enhanced prehospital care, RSI
Suwon, South Korea (Jung, 2016)• Multi-disciplinary staff for severe trauma (5 trauma surgeons, 1 emergency physician, a nurse practitioner and emergency technician
• Emergency technician staffed for minor injuries in inaccessible locations
• Emergency technicians give basic life support procedures with phone support from the hospital medical team
Japan (Abe, 2014)• Doctor and nurse staffed• No specific details provided
Air Ambulance Victoria, Australia (Andrew, 2015)• Intensive Care Flight Paramedic and air crewman• Existing Intensive Care Paramedics complete an additional 9-months’ postgraduate training in aeromedical rescue. Also acquire skills including paediatric RSI, mechanical ventilation, insertion of arterial lines and invasive monitoring, administration of a wider range of medications
• Air crewmen have 120 h training to fulfil the role of Emergency Medical Technician
Greater Sydney Area HEMS, Australia (Burns, 2017)• Doctor and paramedic staffed• Doctors are board-certified senior registrars from Emergency Medicine or Anaesthesia; minimum of 5 years’ postgraduate experience
• Paramedics are critical care specialists with a minimum of 10 years’ experience and additional training in pre-hospital and retrieval medicine.
East Denmark (Afzali, 2013)• Doctor and paramedic staffed• Consultant anaesthesiologist experienced in intensive care pre-hospital
• Paramedic with special training in navigation and radio communication techniques.
Central Denmark (Rognås, 2013)• Doctor and EMT staffed• Anaesthesiologists with at least 4.5 years’ experience in anaesthesia. All work in and outside operating theatre as part of their daily work.
Finland (Heinanen, 2018)• Doctor staffed• Mainly anaesthesiologists specialised in emergency care
France (Desmettre, 2012)• Team from hospital led by emergency physician• No details provided
Dalarna, Sweden (Kornhall, 2018)• Doctor and HEMS crewmember• Doctor has board certification in anaesthesiology
• HEMS crewmember is registered pre-hospital nurse
Pittsburgh, United States (Sperry, 2018)• Paramedic and flight nurse staffed• Not described