Characteristics of helicopter hoist operations with intubated patients: a retrospective analysis of a Norwegian physician staffed SAR helicopter service.

Autor: Skaiaa SC; Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway. scskaiaa@gmail.com., Roslin A; Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway., Heggland T; Department of Anaesthesiology, Intensive Care Medicine and Surgical Services, Førde Central Hospital, Førde, Norway., Heian S; Department of Emergency Medicine and Pre-Hospital Services, St. Olav University Hospital, Trondheim, Norway., Elden T; Air Ambulance Department, Nordland General Hospital, Bodø, Norway., Åreskjold Ø; Clinic of Prehospital Services, Air Ambulance Department, Stavanger Health Trust, Stavanger, Norway., Iversen HR; Emergency Department, Finnmark Hospital, Hammerfest, Norway., Jakobsen DS; RNoAF 330 Squadron Rygge, 1580, Rygge, Norway., Sabel M; Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway., Berve PO; Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
Jazyk: angličtina
Zdroj: Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2024 Nov 21; Vol. 32 (1), pp. 118. Date of Electronic Publication: 2024 Nov 21.
DOI: 10.1186/s13049-024-01289-9
Abstrakt: Background: Timely medical management and evacuation of critically ill or injured patients from austere environments or maritime vessels is often achieved by helicopter hoist operations. When indicated, intubation is performed onsite to restore and sustain patient physiology and to facilitate safe transport. We aimed to describe the characteristics of helicopter hoist operations (HHOs) with intubated patients in a physician staffed SAR helicopter service and to identify learning points for future missions.
Methods: The Norwegian national SAR database and local medical journal systems on six SAR helicopter bases were searched for data on hoisted intubated patients from January 2011 to April 2024.
Results: From a total of 18,710 missions, we registered 2,423 helicopter hoist operations with patients as human external cargo. In 54 hoist operations (2%) the patients were intubated prior to hoisting. We observed an increasing number of both HHOs in general and HHOs with intubated patients over time. The intubated HHO patients were in an overall critical state, with a median NACA score of 6 and a median GCS of 3 before intubation. Trauma was the main cause of intubation (n = 32). Twenty-five patients presented with cardiac arrest, 13 of whom were hoisted with an ongoing mechanical chest compression device. During the hoist operation, 34 patients were ventilated manually, and 20 patients were connected to an automatic ventilator. Monitoring of vital parameters during hoisting varied from none to fully monitored patients including invasive arterial blood pressure. Twenty-eight patients, seven of whom presented with initial cardiac arrest, survived to hospital discharge.
Conclusions: HHOs with intubated patients are rare but increasingly occurring events in our service. Owing to the infrequency, complexity and risk factors involved, these operations should be governed by specific operating procedures and trained regularly to be performed safely. HHOs with intubated patients represents a favourable alternative in situations where terrestrial transport is associated with significant time delay or additional risk to the patient or the rescuers.
Competing Interests: Declarations. Ethics approval: The study was approved by the Data Protection Officer at Oslo University Hospital (reference 24/09587) and was by the Regional Ethics Committee (REK Sør-Øst, reference 767917) deemed as not applicable for clinical trial registration. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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