Abstract 134: Helicopter Teams Improve Outcome from Nontraumatic Cardiac Arrest Compared with Ground Ambulance Services: What Are the Reasons?
Introduction. The use of helicopter emergency medical services (HEMS) for the critically ill has increased significantly over the past decades but different dispatch criteria exist in many European countries. It is unclear, whether HEMS could bring any benefit if used for treatment of out-of-hospital cardiac arrests (OHCA) in regions sufficiently covered with a physician-staffed ambulance system. This study aimed to analyze results of cardiopulmonary resuscitations (CPR) performed by HEMS.
Methods. Three-year retrospective database review. All cases of non-traumatic OHCAs treated by HEMS were analyzed according to the Utstein style recommendations, incl. admission rate, hospital outcome, and 3-month survival measured by Cerebral Performance Categories (CPC). Data were compared to outcome results of the ground ambulance services (EuReCa registry).
Results. There were 1981 HEMS missions (1936 treated patients incl. 313 OHCAs) between January 2009 and December 2011. CPR was attempted in 134 cases. Eighty-six patients developed OHCA of non-traumatic origin and were included in analysis. Return of spontaneous circulation (ROSC) was achieved in 38 (44.2%) cases, hospital admission in 43 (50.0%), and both hospital discharge and 3-month survival (CPC 1-2) in 18 cases (20.9%). Appropriate figures for patients with first shockable rhythms (n=28) were 20 (71.4%) for ROSC, 21 (75.0%) for hospital admission, and 15 (53.6%) for 3-month intact survival. Intubation was performed in 76 (88.4%) patients while mechanical CPR device was used in 27 (31.4%). Forty (93.0%) of 43 admitted patients were transported directly to the University Hospital, and 10 (23.3%) admitted directly to the catheterization laboratory. The recently published outcome results of CPRs performed by ground EMSs in the Czech Republic (rural/urban regions) vary between 30.8% and 56.3% for ROSC, and 5.9% and 15.0% for hospital discharge with intact survival (CPC 1-2).
Conclusion. Dispatch of HEMS for OHCA may improve long-term survival especially in patients with shockable rhythms. HEMS not only provide more experienced personnel, but also can reduce pre-hospital time and offer direct patient’s transport to the most appropriate hospital providing post-resuscitation care.
- © 2012 by American Heart Association, Inc.