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Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?
Eur J Trauma Emerg Surg. 2021 Jun; 47(3):703-711.EJ

Abstract

PURPOSE

The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13th, 2020. The aim of this study was to describe the incidence, type and characteristics of HEMS and HEMS-ambulance 'Lifeliner 1' dispatches during the initial phase of the COVID-19 pandemic compared to the same period one year prior.

METHODS

A retrospective review of all HEMS and HEMS-ambulance 'Lifeliner 1' dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described.

RESULTS

During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8-53).

CONCLUSION

A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances.

LEVEL OF EVIDENCE

III, retrospective comparative study.

Authors+Show Affiliations

Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. q.rikken@amsterdamumc.nl.Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. s.mikdad@amsterdamumc.nl.Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.Department of Anesthesiology, Location AMC and Location VUmc, Amsterdam University Medical Centres, Amsterdam, Netherlands.Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. Department of Anesthesiology, Location AMC and Location VUmc, Amsterdam University Medical Centres, Amsterdam, Netherlands.Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. Department of Anesthesiology, Location AMC and Location VUmc, Amsterdam University Medical Centres, Amsterdam, Netherlands.Trauma Center, Department of Surgery, Location AMC and Location VUmc, Amsterdam University Medical Centres, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33438040

Citation

Rikken, Quinten G H., et al. "Operational Experience of the Dutch Helicopter Emergency Medical Services (HEMS) During the Initial Phase of the COVID-19 Pandemic: Jeopardy On the Prehospital Care System?" European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, vol. 47, no. 3, 2021, pp. 703-711.
Rikken QGH, Mikdad S, Mota MTC, et al. Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system? Eur J Trauma Emerg Surg. 2021;47(3):703-711.
Rikken, Q. G. H., Mikdad, S., Mota, M. T. C., De Leeuw, M. A., Schober, P., Schwarte, L. A., & Giannakopoulos, G. F. (2021). Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system? European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society, 47(3), 703-711. https://doi.org/10.1007/s00068-020-01569-w
Rikken QGH, et al. Operational Experience of the Dutch Helicopter Emergency Medical Services (HEMS) During the Initial Phase of the COVID-19 Pandemic: Jeopardy On the Prehospital Care System. Eur J Trauma Emerg Surg. 2021;47(3):703-711. PubMed PMID: 33438040.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system? AU - Rikken,Quinten G H, AU - Mikdad,Sarah, AU - Mota,Mathijs T Carvalho, AU - De Leeuw,Marcel A, AU - Schober,Patrick, AU - Schwarte,Lothar A, AU - Giannakopoulos,Georgios F, Y1 - 2021/01/12/ PY - 2020/09/08/received PY - 2020/12/02/accepted PY - 2021/1/14/pubmed PY - 2021/1/14/medline PY - 2021/1/13/entrez KW - COVID-19 KW - Helicopter emergency medical services KW - SARS-CoV2 KW - Trauma SP - 703 EP - 711 JF - European journal of trauma and emergency surgery : official publication of the European Trauma Society JO - Eur J Trauma Emerg Surg VL - 47 IS - 3 N2 - PURPOSE: The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13th, 2020. The aim of this study was to describe the incidence, type and characteristics of HEMS and HEMS-ambulance 'Lifeliner 1' dispatches during the initial phase of the COVID-19 pandemic compared to the same period one year prior. METHODS: A retrospective review of all HEMS and HEMS-ambulance 'Lifeliner 1' dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described. RESULTS: During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8-53). CONCLUSION: A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances. LEVEL OF EVIDENCE: III, retrospective comparative study. SN - 1863-9941 UR - https://www.unboundmedicine.com/medline/citation/33438040/Operational_experience_of_the_Dutch_helicopter_emergency_medical_services__HEMS__during_the_initial_phase_of_the_COVID_19_pandemic:_jeopardy_on_the_prehospital_care_system L2 - https://dx.doi.org/10.1007/s00068-020-01569-w DB - PRIME DP - Unbound Medicine ER -