Clinical Interventions Account for Scene Time in a Helicopter Emergency Medical Service in South Africa

Abstract

Introduction: Helicopter emergency medical services (HEMS) have been associated with a prolonged scene time, compromising the time benefit in an urban setting. Therefore, the clinical benefit offered through additional equipment, skills, and experience of HEMS crews must be investigated to propose the value of HEMS. This study aimed at establishing whether HEMS scene time was associated with the number of clinical interventions performed and improved patient stability.

Method: This retrospective, cross-sectional chart review included all primary HEMS cases from June 1, 2013, to May 31, 2015, from a South African helicopter service and extracted the number of clinical interventions and patient stability using the Mainz Emergency Evaluation Score (MEES). We correlated this with scene time using analysis of variance.

Results: Five hundred fourteen clinical interventions were performed on 204 patients. A median of 2 clinical interventions per patient was performed on scene. Performing 1 additional clinical intervention was associated with an approximate 4-minute increase in on-scene time. Some improvement in patient stability was shown by a mean change in the MEES of 0.65 after on-scene intervention, but this did not reach MEES clinical cutoff measures.

Conclusion: The number of clinical interventions performed by helicopter crews can account for scene time in a South African HEMS. The clinical interventions performed by helicopter crews tend to have a positive effect on patient stability.