A 5-year analysis of the helicopter air mercy service in Richards Bay, South Africa
Background. A helicopter emergency medical service (HEMS) was established in 2005 in Richards Bay, KwaZulu-Natal, South Africa, to provide primary response and inter-facility transfers to a largely rural area with a population of 3.4 million people.
Objective. To describe the first 5 years of operation of the HEMS.
Methods. A chart review of all flights from 1 January 2006 to 31 December 2010 was conducted.
Results. A total of 1 429 flights were undertaken; 3 were excluded from analysis (missing folders). Most flights (88.4%) were inter-facility transfers (IFTs). Almost 10% were cancelled after takeoff. The breakdown by age was 61.9% adult, 15.1% paediatric and 21.6% neonate. The main indications for IFTs were obstetrics (34.5%), paediatrics (27.9%) and trauma (15.9%). For primary response most cases were trauma (72.9%) and obstetrics (11.3%). The median on-scene time for neonates was significantly longer (48 min, interquartile range (IQR) 35 - 64 min) than that for adults (36 min, IQR 26 - 48; p<0.001) and paediatrics (36 min, IQR 25 - 51; p<0.02). On-scene times for doctor-paramedic crews (45 min, IQR 27 - 50) were significantly longer than for paramedic-only crews (38 min, IQR 27 - 57; p<0.001).
Conclusion. The low flight-to-population ratio and primary response rate may indicate under-utilisation of the air medical service in an area with a shortage of advanced life support crews and long transport distances. Further studies on HEMSs in rural Africa are needed, particularly with regard to cost-benefit analyses, optimal activation criteria and triage systems.
Patrick Andrew D'Andrea, Division of Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
Daniël Jacobus van Hoving, Division of Emergency Medicine, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
Darryl Wood, Division of Emergency Medicine, Faculty of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
Wayne Patrick Smith, Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
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Date published: 2013-11-20
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