Identification of the technical and medical requirements for HEMS avalanche rescue missions through a 15-year retrospective analysis in a HEMS in Switzerland: a necessary step for quality improvement.

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License: CC BY 4.0
Serval ID
serval:BIB_04A86CE2B39A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Identification of the technical and medical requirements for HEMS avalanche rescue missions through a 15-year retrospective analysis in a HEMS in Switzerland: a necessary step for quality improvement.
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
Author(s)
Kottmann A., Carron P.N., Theiler L., Albrecht R., Tissi M., Pasquier M.
ISSN
1757-7241 (Electronic)
ISSN-L
1757-7241
Publication state
Published
Issued date
04/07/2018
Peer-reviewed
Oui
Volume
26
Number
1
Pages
54
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Avalanche rescues mostly rely on helicopter emergency medical services (HEMS) and include technical rescue and complex medical situations under difficult conditions. The adequacy of avalanche victim management has been shown to be unexpectedly low, suggesting the need for quality improvement. We analyse the technical rescue and medical competency requirements of HEMS crewmembers for avalanche rescue missions, as well as their clinical exposure. The study aims to identify areas that should be the focus of future quality improvement efforts.
This 15-year retrospective study of avalanche rescue by the Swiss HEMS Rega includes all missions where at least one patient had been caught by an avalanche, found within 24 h of the alarm being raised, and transported.
Our analyses included 422 missions (596 patients). Crews were frequently confronted with technical rescue aspects, including winching (29%) and patient location and extrication (48%), as well as multiple casualty accidents (32%). Forty-seven percent of the patients suffered potential or overt vital threat; 29% were in cardiac arrest. The on-site medical management of the victims required a large array of basic and advanced medical skills. Clinical exposure was low, as 56% of the physicians were involved in only one avalanche rescue mission over the study period.
Our data provide a solid baseline measure and valuable starting point for improving our understanding of the challenges encountered during avalanche rescue missions. We further suggest QI interventions, that might be immediately useful for HEMS operating under similar settings. A coordinated approach using a consensus process to determine quality indicators and a minimal dataset for the specific setting of avalanche rescue would be the logical next step.
Keywords
Adult, Air Ambulances/organization & administration, Avalanches, Emergency Medical Services/organization & administration, Female, Humans, Male, Middle Aged, Quality Improvement, Retrospective Studies, Switzerland, Avalanche, Clinical exposure, HEMS, Mission, Quality improvement, Requirements, Rescue, Technical rescue
Pubmed
Web of science
Open Access
Yes
Create date
29/07/2018 13:10
Last modification date
20/08/2019 13:26
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