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Emerg Med J doi:10.1136/emermed-2012-201879
  • Original article

Are physicians required during winch rescue missions in an Australian helicopter emergency medical service?

  1. Karel Habig
  1. Department of Pre-hospital Care, Greater Sydney Area Helicopter Emergency Medical Service (GSA-HEMS), Sydney, New South Wales, Australia
  1. Correspondence to Dr Peter Brendon Sherren, Department of Pre-hospital Care, Greater Sydney Area HEMS Sydney, NSW 2011, Australia; petersherren{at}gmail.com
  • Received 16 August 2012
  • Revised 8 November 2012
  • Accepted 6 January 2013
  • Published Online First 26 January 2013

Abstract

Background A helicopter emergency medical service (HEMS) capable of winching offers several advantages over standard rescue operations. Little is known about the benefit of physician winching in addition to a highly trained paramedic.

Objective To analyse the mission profiles and interventions performed during rescues involving the winching of a physician in the Greater Sydney Area HEMS (GSA-HEMS).

Methods All winch missions involving a physician from August 2009 to January 2012 were identified from the prospectively completed GSA-HEMS electronic database. A structured case sheet review for a predetermined list of demographic data and physician-only interventions (POIs) was conducted.

Results We identified 130 missions involving the winching of a physician, of which 120 case sheets were available for analysis. The majority of patients were traumatically injured (90%) and male (85%) with a median age of 37 years. Seven patients were pronounced dead at the scene. A total of 63 POIs were performed on 48 patients. Administration of advanced analgesia was the most common POI making up 68.3% of interventions. Patients with abnormal RTSc2 scores were more likely to receive a POI than those with normal RTSc2 (84.8% vs 15.2%; p=0.03). The performance of a POI had no effect on median scene times (45 vs 43 min; p=0.51).

Conclusions Our high POI rate of 40% (48/120) coupled with long rescue times and the occasional severe injuries support the argument for winching Physicians. Not doing so would deny a significant proportion of patients time-critical interventions, advanced analgesia and procedural sedation.