A five year analysis of the rotor wing air mercy service in Richards Bay, South Africa
Date
2013-12
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY : Introduction: The study describes the first five years of operation of a HEMS service in rural South Africa.
Methods: A chart review of all activated flights from 1 January 2006 to 31 December 2010 was
conducted. Flights with missing patient report forms were excluded. Data collected included age,
indication for flight, triage code, flight times, on-scene times, presence of doctor as part of crew, and
whether the flight was for a primary response or inter-facility transfer.
Results: 1429 flights were undertaken; three records were missing. Primary response accounted for
165 (11.57%) of flights. 139 (9.75%) flights were cancelled after take off (Interfacility Transfer (IFT)
n=99, 7.9%; Primary n=32, 19.4%; unspecified n=8). Just over a third (n=472, 36.67%, IFT n=447,
38.74%; Primary n=25, 18.80%) of patients were under twelve years old. The main indications for
flight in IFT were obstetrics (n=398, 34.49%), paediatrics (n=322, 27.90%), and trauma (n=183,
15.86%). In primary response trauma (n=97, 72.93%) was most common followed by obstetrics
(n=15, 11.28%), and paediatrics (n=9, 6.78%). However the triage system used appeared to be
subjective and inconsistent. There was a significantly longer median on-scene time for neonates (48
minutes, IQR 35-64 minutes) as compared to adults (36 minutes, IQR 26-48 minutes, p<0.001) and
paediatrics (36 minutes, IQR 25-51 minutes, p<0.02). On-scene times for doctor-paramedic crews (45
minutes, IQR 27-50) were significantly longer than paramedic only crews (38 minutes, IQR 27-57,
p<0.001).
Conclusion: The low flight per population ratios and primary response rate may indicate underutilisation
of HEMS in an area where it may have a major impact considering the shortage of ALS
crew and the long transport distances. There is a need for further studies into HEMS in rural Africa,
looking particularly at cost-benefit analyses, optimal activation criteria, and triage systems.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
AFRIKAANSE OPSOMMING : Geen opsomming beskikbaar.
Description
Thesis (MMed)--Stellenbosch University, 2013.
Keywords
Helicopter ambulances -- South Africa, South African Red Cross Air Mercy Service, South African Red Cross Society. National Health Department -- South Africa, Air medical services -- South Africa, UCTD