Trauma Care

In July 2017, Northern Ireland (N.I.) witnessed the inception of its Helicopter Emergency Medical Service (HEMS) – a milestone in the region’s medical and emergency response system. After years of planning and coordination, the HEMS has become an integral part of N.I.’s capacity to deliver life-saving care to the critically injured. This article provides an analysis of HEMS’s contribution through the lens of its first 100 cases. The analysis uncovers vital insights into the demographics impacted, the nature of traumatic incidents encountered, and the outcomes achieved by this service.

As the latest addition to the UK’s network of airborne medical services, N.I.’s HEMS represents a significant evolution in emergency medical care provision. The hand-trawled data presents a cross-section of incidents from all counties, with the majority of incidents occurring in Co. Antrim. Of the patients treated, 83% were male, with a broad age range from adolescents to nonagenarians.

The predominant cause of trauma was road traffic collisions. This finding aligns with reported data from the Great Britain Department for Transport, highlighting the prevalence and risk of road incidents. In these critical situations, the rapid deployment of HEMS means the difference between life and death. The severity of trauma demands rapid and efficient medical interventions – HEMS has facilitated this through procedures such as pre-hospital anesthesia, thoracostomies, and enhanced pain management techniques.

Despite the diverse nature and location of these incidents, one consistent factor in the HEMS operations was the presence of a consultant and paramedic at every scene. This level of expertise provided allows for decisive and sophisticated on-site medical care. In total, thirteen patients were tragically declared deceased at the scene. However, ninety percent of those who were transported to hospitals were alive 24 hours later – a testament to the swift and advanced care provided by HEMS teams.

Comparing the data from N.I.’s HEMS with other UK data reveals considerable parallels in gender profile, mechanism of injury, and rates of rapid sequence intubation (RSI) for vulnerable road users. The RSI rates in N.I. have been found comparable to other studies emphasizing the meticulous critical care provided in the face of multi-trauma emergencies.

The launch of HEMS in N.I. has not only augmented the region’s trauma response network but has also served as a critical learning resource. By scrutinizing interventions and outcomes, HEMS can continually refine its processes to improve patient survival and recovery rates. The published findings from the evaluation of their initial cases, detailed in The Ulster Medical Journal, shed light on the significance of having such dedicated air ambulance services.

Looking ahead, it is apparent that the data amassed by HEMS will continue to guide service enhancements, policy formulation, and the development of best practices for emergency medical services. The importance of publishing this data cannot be overstated, as it adds to the collective knowledge on trauma care and emergency medical response efficacy.

For researchers and policymakers alike, the published data with a DOI of 10.3318/ulstermedj.88.2.98 and references from peer-reviewed journals and authoritative organizations serves as both a foundational and innovative resource in advancing trauma medical services in Northern Ireland and beyond.

Keywords

1. Helicopter Emergency Medical Service
2. HEMS Northern Ireland
3. Pre-Hospital Trauma Care
4. Air Ambulance NI
5. Road Traffic Collision Emergency Response

References

1. Boylan, E. E., McLaughlin, R. R., O’Rorke, G. G., Thorpe, R., & Monaghan, D. (2019 May). Helicopter Emergency Medical Service (HEMS) in Northern Ireland: An Analysis of the First 100 Cases. Ulster Med J, 88(2), 98–101. DOI: 10.3318/ulstermedj.88.2.98. PMC6500403z

2. Kehoe, A., Smith, J. E., Edwards, A., Yates, D., & Lecky, F. (2015). The changing face of major trauma in the UK. Emerg Med J, 32(12), 911–5. DOI: 10.1136/emermed-2015-204980. PMC4717354

3. Sunde, G., Heltne, J., Lockey, D., Burns, B., Sandberg, M., Fredriksen, K., & Airway management by physician-staffed Helicopter Emergency Medical Services – a prospective, multicentre, observational study of 2,327 patients. (2015). Scand J Trauma Resusc Emerg Med, 23(57), 1–10. DOI: 10.1186/s13049-015-0136-9. PMC4528299

4. Brake The Road Safety Charity. (2019). Driver gender. Retrieved from http://www.brake.org.uk/facts-resources/1593-driver-gender

5. Great Britain Department for Transport. (2018). Reported road casualties in Great Britain: 2017 annual report. Retrieved from https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/744077/reported-road-casualties-annual-report-2017.pdf

6. GAIN: Guideline and Audit Implementation Network and The Regulation and Quality Improvement Authority. (2016). Northern Ireland Trauma Audit: February 2016. Retrieved from https://www.rqia.org.uk/RQIA/files/49/494ff427-9511-4311-bcca-db5fe7bc3eca.pdf

7. TARN: The Trauma Audi & Research Network. (2018). Major trauma in older people: England and Wales. Retrieved from https://www.tarn.ac.uk/content/downloads/3793/Major%20Trauma%20in%20Older%20People%202017.pdf