Challenges of helicopter mountain rescue missions by human external cargo: need for physicians onsite and comprehensive training

Urs Pietsch, Giacomo Strapazzon, Dimitri Ambühl, Volker Lischke, Simon Rauch, Jürgen Knapp, Urs Pietsch, Giacomo Strapazzon, Dimitri Ambühl, Volker Lischke, Simon Rauch, Jürgen Knapp

Abstract

Background: Human external cargo (HEC) extrication during helicopter rescue missions is commonly used in mountain emergency medical services. Furthermore, longline or winch operations offer the opportunity to deliver professional medical care onsite. As the safety and quality of emergency medical care depends on training and experience, we aimed to investigate characteristics of mountain rescue missions with HEC.

Methods: We retrospectively reviewed all rescue missions conducted by Air Zermatt (a commercial rescue service in the high-alpine region of Switzerland) from January 2010 to September 2016.

Results: Out of 11,078 rescue missions 1137 (10%) required a HEC rescue. In 3% (n = 29) rapid sequence induction and endotracheal intubation, in 2% (n = 14) cardiopulmonary resuscitation, and in 0.4% (n = 3) a chest tube insertion had to be performed onsite prior to HEC extraction. The most common medical intervention onsite is analgesia or analgosedation, in 17% (n = 142) fentanyl or ketamine was used in doses of ≥ 0.2 mg or ≥ 50 mg, respectively.

Conclusions: As these interventions have to be performed in challenging terrain, with reduced personnel resources, and limited monitoring, our results point out the need for physicians onsite who are clinically experienced in these procedures and specially and intensively trained for the specific characteristics and challenges of HEC rescue missions.

Keywords: Alpine rescue; Emergency medicine; Helicopter emergency medical service; Training; Trauma.

Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Swiss Ethics Committees on research involving humans, Project ID: 2017–00142.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
HEMS rescue missions between January 2010 and September 2016 and patient selection. HEC human external cargo mission, NACA National Advisory Committee for Aeronautic

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Source: PubMed

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