Helicopter Emergency Medical Service (HEMS) in Northern Ireland: An Analysis of the First 100 Cases

INTRODUCTION: Northern Ireland (N.I) is the most recent region within the UK to establish a helicopter emergency medical service (HEMS) which became operational in July 2017.(1) We present descriptive data and discussion about the first 100 cases managed by this new trauma service. Some call-outs involved multiple cases. The data covers a period of 130 days from late July 2018 to late November 2018. METHODS: Information from all HEMS cases was captured manually and records retained for governance purposes. For the purpose of this paper we conducted a hand trawl of records relating to the first 100 cases managed by the HEMS team. Data was entered into a database for the purpose of analysis. Measured data included: location of incident, mode of dispatch, patient demographics, mechanism of injury, interventions provided, destination (hospital) and outcome at 24hours. RESULTS: Patients were treated in all counties of N.I., most frequently in Co. Antrim. 83% of patients were male. Age range was between 3 years old and 97 years old. The most common mechanism of injury was road traffic collision; others included fall from height, animal attacks, electrocution, drowning and burns. All cases were assessed by a consultant and paramedic. Interventions included: pre hospital anaesthesia using rapid sequence intubation (RSI), thoracostomies, enhanced drug therapy (EDT) for pain management, procedural sedation or fracture reduction (FR) and administration of hypertonic saline (HTS). Thirteen patients were declared deceased on scene. Five required no further transportation (medically or self-discharged). Of the remainder, 90% were alive at 24 hours. DISCUSSION: There has been considerable learning in the early stages and analysis of this data has indicated: Since starting the service we have provided critical interventions to a wide variety of age groups throughout NI. Gender profile, mechanism of injury, vulnerable road users (defined as motorcyclists, pedal cyclists and pedestrians) and RSI rates are comparable to data published in the UK. (2,3,4,5) The Royal Victoria Hospital (RVH) emergency department (ED) was the receiving unit for most patients attended by HEMS. 90% of all patients transferred to hospital were alive at 24 hours.