Introduction Sea King SAR helicopters are a familiar sight to UK mountain users, mariners and fans of TV's “Highland Emergency”! However, their medical activity is not routinely analysed. We wished to assess the nature of cases attended and the equipment/drugs/skills utilised by SAR winchmen, to ensure the applicability of winchman training programmes.

Method Following every military SAR call-out (RAF/Royal Navy) a formal report is sent to SAR Force Headquarters. These reports for incidents 1 January 2009–31 December 2009 were scrutinised and data extracted.

Results

• There were 767 jobs involving medical activity in the 1-year period (plus 31 body recoveries).

• Age 6 months–98 years (mean 43, median 42); 71% male

• Trauma 57%, Medical 42%, Chemical 1%: some had combined problems.

• 169/798 (21%) were jointly managed with other agencies (eg, ambulance; Mountain Rescue; Maritime & Coastguard Agency; RNLI)

• 19% of jobs were at sea; 13% involved >1 casualty

• During the 1-year period, winchmen performed 5 needle thoracocenteses, 15 intubations, 181 cannulations, and applied 105 limb splints and 9 pelvic splints.

• 63/767 (8%) were given IV fluids; 92 (12%) received morphine.

• Winchmen cared for 30 casualties given drugs by other providers including midazolam, intranasal diamorphine, pethidine and ketamine.

• 59 casualties had a documented GCS of 8 or less including 44 in cardiac arrest.

Of the 470 trauma cases (25% of which had fallen from height), 41% had lower limb injuries, 28% possible neck/spinal/back injury, 26% head/facial injuries and 8.5% chest injuries. Of the medical problems, 17% had chest pain, 15% neurological/vascular, 10% abdominal problems, 4% O&G and 4% “medical paeds”.

Conclusion RAF/RN winchmen deal with a wide variety of cases, of all ages. Considering that, typically, 70% of the 70 winchmen at any time are qualified paramedics (the remainder are technician-level) advanced skills are used moderately frequently.