A 5-year analysis of the helicopter air mercy service in Richards Bay, South Africa

• Published in: South African medical journal Vol. 104; no. 2; pp. 124 - 126
• Main Authors: Wood, D., D'Andrea, P.A., Smith, W.P., Van Hoving, D.J.
• Format: Journal Article
• Language: English
• Published: South Africa Health and Medical Publishing Group (HMPG) 01.02.2014; Health & Medical Publishing Group
• Subjects: Air Ambulances; Emergency Medical Services - organization & administration; Emergency medicine; Forecasts and trends; Helicopter ambulances; Humans; Medical care; Medical research; Medicine, Experimental; Patient Transfer - statistics & numerical data; Retrospective Studies; Rural Population; South Africa; Statistics; Utilization; South Africa
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.7310

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.