Prehospital anaesthesia by a helicopter emergency medicine service: a review

Abstract

Background: The Northern Ireland (NI) Ambulance Service launched its helicopter emergency medical service (HEMS) in 2017. Aims: This paper reviews the first 200 cases of prehospital emergency anaesthesia (PHEA). Methods: A retrospective review of the NI HEMS intubation database between 29 July 2017 and 28 February 2021 was conducted. Findings: PHEA was delivered as rapid sequence intubation (RSI). There was a 100% RSI success rate. The mean 999 call to RSI time was 65.9 minutes (median=61 minutes), with 14.6% of procedures carried out within the National Institute for Health and Care Excellence target of 45 minutes or less. The first pass oral intubation rate was 89.3%. There was a significant difference in the number of male compared to female patients (men=145; women=55; P≤0.0001). Conclusion: PHEA delivery by the HEMS since it was set up has been successful provided in a safe, robust manner. Reducing the 999 call to RSI time in line with the National Institute for Health and Care Excellence target was identified as an area for development.