No abstract available.
Air Ambulances* ; Emergencies*

OBJECTIVE: Helicopter ambulance transport (HAT) is a highly resource-intensive facility that is a well-established part of the trauma transport system in many developed countries. Here, we review the benefit of HAT for neurosurgical patients in Korea. METHODS: This retrospective study followed neurotrauma patients who were transferred by HAT to a single emergency trauma center over a period of 2 years. The clinical benefits of HAT were measured according to the necessity of emergency surgical intervention and the differences in the time taken to transport patients by ground ambulance transport (GAT) and HAT. RESULTS: Ninety-nine patients were transferred to a single university hospital using HAT, of whom 32 were taken to the neurosurgery department. Of these 32 patients, 10 (31.3%) needed neurosurgical intervention, 14 (43.8%) needed non-neurosurgical intervention, 3 (9.4%) required both, and 11 (34.4%) did not require any intervention. The transfer time was faster using HAT than the estimated time needed for GAT, although for a relatively close distance (<50 km) without ground obstacles (mountain or sea) HAT did not improve transfer time. The cost comparison showed that HAT was more expensive than GAT (3,292,000 vs. 84,000 KRW, p<0.001). CONCLUSION: In this Korean-based study, we found that HAT has a clinical benefit for neurotrauma cases involving a transfer from a distant site or an isolated area. A more precise triage for using HAT should be considered to prevent overuse of this expensive transport method.
Air Ambulances* ; Ambulances ; Developed Countries ; Emergencies ; Humans ; Korea ; Neurosurgery ; Retrospective Studies ; Trauma Centers ; Triage

The development of burn units in our country is now undergoing a trend of geographic centralization and regionalization. To solve the problems like severe burn patients are too far away from burn units, overloaded operation in regional burn centers when mass burn accidents happen, and growing requirement for aeromedical transportation, etc., it is now the top priority to improve national aeromedical transportation system for burn patients. Expert teams from Chinese Burn Association, National Aeromedical Rescue Base, and China Association for Disaster & Emergency Rescue Medicine discussed and reached a consensus on the key points of aeromedical transportation of burn patients, including organizational structure, staff and materials, and three links before, during, and after aeromedical transportation. The consensus aims to provide guidance for a safe, efficient, and standardized operation of aeromedical transportation for burn patients in China.
Accidents ; Air Ambulances ; Burn Units ; Consensus ; Disasters ; Humans

PURPOSE: The Ministry of Health and Welfare of korea started operating the Helicopter Emergency Medical Service (HEMS) System in 2011 to improve emergency medical services given by physicians aboard helicopters. The purpose of this study was to evaluate the HEMS education program for its effectiveness and satisfaction from trainees. METHODS: A survey of trainees was conducted at the very end of training and education. Trainees for a HEMS crew surveyed included doctors (8), nurses (4), emergency medical technicians (12), pilots (10), flight dispatchers (4) and an administrator (1). The study period was from August 8, 2011 to August 12, 2011. The amount of HEMS education was 16 hours, including 8 hours of theoretical education, 5 hours of simulation and 3 hours of table-top simulation. RESULTS: In an analysis of programs according to trainee satisfaction, the theoretical training program received an average of 4.2+/-0.7 points and; the practical and simulation training program received; 4.4+/-0.8 points. The simulated practical training program thus received a higher score than theoretical education, but the difference was insignificant (p=0.834). CONCLUSION: For the HEMS training programs, the practical and simulation training satisfaction score were higher than the theoretical program. A focus on simulation programs for HEMS could therefore serve as a goal of the HEMS education program.
Administrative Personnel ; Air Ambulances ; Aircraft ; Emergency Medical Services ; Emergency Medical Technicians ; Humans ; Korea ; Republic of Korea

Multiple variables can influence triage decision in multiple trauma. Recognition of priorities and selection of the destination can be successfully achieved by field triage and individualized clinical judgment. This narrative review summarizes the new options and protocols for transport of injured subjects. There are four levels of emergency medical providers including first responders and three levels of emergency medical technicians. Two distinct accepted protocols for transport are known as scoop and run and treat and then transfer. The former provides minimum lifesaving treatment at the scene of accident followed by transferring the patient(s) as soon as possible, and the latter mainly emphasizes the need for complete stabilization as a prerequisite for safe transport. The destination and mode of transport are selected according to clinical capabilities of the receiving hospital, transfer time from the scene to the facility, patient's medical condition, accessibility of the scene, and weather. Two common methods of transfer are ground transport, including various type of ambulances, and air medical transport, i.e. helicopter and airplane.
Air Ambulances ; Decision Making ; Humans ; Mass Casualty Incidents ; Multiple Trauma ; therapy ; Transportation of Patients ; organization & administration ; Triage

OBJECTIVETo analyze the opportunity and condition of aeromedical transportation in critically burn patients.

METHODSEighteen severely burn patients were operated by aeromedical transportation. Among them, four patients were transported in the shock stage and fourteen patients were transported after shock stage. Some aspects of treatment were introduced including escharectomy,clinical index, equipment of medicine, and so on. The transportation card and abstract of case file were recorded carefully before aeromedical transportation. When there were over 2 patients, those with more severe burns received the treatment in the priority.

RESULTSEach aeromedical transportation airplane carried 1 to 6 cases, and flies 420 to 2 500 km for 1.5 to 3. 5 hours. The patients were safely arrived at destination. Except one died for multiple organ failure, others were cured during further treatment.

CONCLUSIONProvide that the conditions were permissive and preparation were adequate, it is safe to carry out aeromedical transportation during shock stage.

Adolescent ; Adult ; Air Ambulances ; Burns ; therapy ; Critical Illness ; Humans ; Male ; Shock ; therapy ; Young Adult

Recent evidence has demonstrated the survival benefits of helicopter transport for trauma patients. The purpose of this study was to evaluate the effectiveness of hospital-based helicopter emergency medical services (H-HEMS) in comparison with ground ambulance transport in improving mortality outcomes in patients with major trauma. Study participants were divided into 2 groups according to type of transport to the trauma center; that is, either via ground emergency medical services (GEMS) or via H-HEMS. The study was conducted from October 2013 to July 2015. Mortality outcomes in the H-HEMS group were compared with those in the GEMS group by using the Trauma and Injury Severity Score (TRISS) analysis. The number of participants finally included in the study was 312. Among these patients, 63 were adult major trauma patients transported via H-HEMS, and 47.6% were involved in traffic accidents. For interhospital transport, the Z and W statistics revealed significantly higher scores in the H-HEMS group than in the GEMS group (Z statistic, 2.02 vs. 1.16; P = 0.043 vs. 0.246; W statistic, 8.87 vs. 2.85), and 6.02 more patients could be saved per 100 patients when H-HEMS was used for transportation. TRISS analysis revealed that the use of H-HEMS for transporting adult major trauma patients was associated with significantly improved survival compared to the use of GEMS.
Accidents, Traffic ; Adult ; Air Ambulances ; Aircraft* ; Ambulances ; Emergencies* ; Emergency Medical Services* ; Humans ; Injury Severity Score ; Mortality* ; Transportation ; Trauma Centers ; Wounds and Injuries

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.
Aerospace Medicine ; Air Ambulances ; Aircraft ; Airports ; Chronic Disease ; Critical Illness ; Curriculum ; Defibrillators ; Economic Development ; Emergencies ; First Aid ; Humans ; Korea ; Transportation

With a steady economic growth and the advancement of aircraft design, the demand to travel by air has constantly been on the rise. So much to the fact that there are more than 10 billion people traveling all over the world by aircraft. This demand will continue to rise so long as air travel continues to surpass other methods of transportation in aspects such as speed, comfort, safety, etc. There are about seven million tourists who travel abroad annually in our nation, thus airline travel has become one of the most popular forms of public transport. However, some people travel on flights without considering their state of health and risk suffering from a health ailment while on board. The cabin environment of a modernized aircraft preserves conditions similar to that on the ground, thereby making the travelers feel comfortable. But sometimes people with chronic diseases can make their health condition worse due to long distance flight travel. Traveling overseas among the elder generation has increased, and cases involving patients traveling abroad to receive better medical treatment has increased as well. In advanced countries, the air ambulance system is well prepared, but in Korea we can only transfer patients by commercial airlines based on the destination. This is especially typical in Jeju where there are no alternative ways. Helping an emergency patient inside the cabin is not a simple matter, and therefore it is best to avoid the situation. To be prepared for emergencies, each aircraft has an Emergency Medical Kit, First Aid Kit and Automated External Defibrillator (AED) inside the cabin. Each airline is also developing curriculums for teaching First Aid and training their flight attendants to properly use the Kit, AED and how to give First Aid. If there is a patient with a critical illness, generally the aircraft would land at the closest airport instead of the destination in an attempt to save the precious life. But, it would be more effective to be prepared with a contingency plan beforehand, instead of thereafter. If physicians and patients take more concerns regarding airline travel and kept in close communication with the airlines, some inflight medical emergencies in the cabin can be prevented. A patient who is planning to travel by air would want to receive some aero-medical information from their physicians. It is necessary to understand the cabin environment and to receive information on airline travel myths, the maximum amount of safe time for traveling, and steps to prepare before they leave. In this article, as a physician, I will review the medical guidelines to prevent unexpected accidents or inflight emergencies, and also to have some aviation medicine knowledge to help those on board.
Aerospace Medicine ; Air Ambulances ; Aircraft ; Airports ; Chronic Disease ; Critical Illness ; Curriculum ; Defibrillators ; Economic Development ; Emergencies ; First Aid ; Humans ; Korea ; Transportation

PURPOSE: The number of patients transported by the Helicopter Emergency Medical Service (HEMS) has increased recently. In our review of the Korean HEMS, there was no established helicopter utilization criteria or triage tool on the scene, so many patients with minor injuries were transported to tertiary care centers. The aim of this study is to evaluate the percentage of patients with minor injuries and to propose a more appropriate triage tool for predicting the need for transport to a tertiary care center. METHODS: The subjects of this study were 59 trauma patients transported to Asan Medical Center (AMC) from the scene by Seoul HEMS from January 2004 to December 2005. The Triage score (TS), Injury Severity Score (ISS), and modified Canadian Triage and Acuity Scale (mCTAS) were calculated as severity scales. Patients with minor injuries were defined as those with TS=9, ISS< or =15, and mCTAS> or =3. We evaluated the association of TS, ISS, and mCTAS with the appropriateness of transport. RESULTS: Many of the patients transported to tertiary medical centers were classified as having a minor injury: TS=9 group 35 cases (72.9%), ISS< or =15 group 30 cases (62.5%) and mCTAS> or =3 group 27 cases (56.2%). However, 56.2% (27/59) of the patients were appropriately transported according to need for admission or an operation. The more severely injured patients classified by TS, ISS, and mCTAS were more appropriately transported to a tertiary center (p<0.05). CONCLUSION: Many patients with minor injuries were transported to a tertiary center from the scene directly. The TS can be easily calculated by an emergency medical technician at the scene. Thus, we propose the TS as a useful triage tool for determining the necessity of transport to a tertiary center by helicopter.
Air Ambulances ; Aircraft* ; Chungcheongnam-do ; Emergency Medical Services ; Emergency Medical Technicians ; Humans ; Injury Severity Score ; Seoul ; Tertiary Care Centers* ; Tertiary Healthcare* ; Triage* ; Weights and Measures