Introduction: Medical helicopter services provide several advantages,like the ability to perform air searches for lost victims, a rapid method ofshuttling rescue personnel and equipment to the victim, and the deliveryof early on-site advance medical care. When landing is not possible, therescuers can also be directly winched to the victim. As outdoor activitiesare increasing, few data are available about the type of accidentsleading to a rescue operation involving the use of the winch. We soughtto study the epidemiology and accidentology of such rescues.Methods: We retrospectively reviewed the medical reports of a singlehelicopter-based emergency medical service. Data from 1 January 2003to 31 December 2008 were analyzed. Cases with emergency callindicating that the victim was deceased were excluded. Data includedthe age and gender of the patients, the type of patients activitypreceeding the injury, the mecanism of injury, and the type of lesions(main diagnosis).Results: 9879 rescue missions were conducted between 1 January2003 and 31 December 2008. The 921 (9.3%) missions involvingwinching of the emergency physician were analysed. The male:femaleratio of the patients was 2:1. There were 56 (6%) patients aged 15 orunder. Most of the patients, while injured, were practising winter sportsor mountain-related activities in the summer (table 1). Falls accountedfor the great majority of the trauma events (700 patients or 76%),followed by illnesses (81 patients or 9 %). Of the 921 missions in whichthe physician was winched in the field, 28 (3%) were avalanche rescuesand 13 (1%) were glacier crevasse rescues. Trauma to the upper andlower extremities accounted for 429 (47%) of all injuries, followed by175 (19%) head injuries and 108 (12%) spinal lesions. Hypothermia,frostbite and altitude illnesses were diagnosed in 11 (1%) cases.In 128(14%) cases two different diagnoses were made, and in 69 (7%) threeor more diagnoses.Conclusions: In our helicopter emergency base, between 2003 and2008, 921 rescue missions (9.3%) involved winching of the emergencydoctor. Patients rescued using the winch usually practice outdoorsports, and are predominantly male. The mechanism of the injury isusually a fall, and extremities and head injuries account for more than50% of the main diagnosis made on the field.