title: Helicopter emergency medical services response to equestrian accidents.
abstract: BACKGROUND
  Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre.
  
  
  METHODS
  Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 2012). All missions were screened for accidents involving a horse. Call details, patient demographics, suspected injuries, clinical interventions and patient disposition were all analysed.
  
  
  RESULTS
  In the 12-month data collection period there were 47 equestrian accidents, representing ∼3% of the total annual missions. Of the 42 cases HEMS attended, one patient was pronounced life extinct at the scene. In 15 (36%) cases the patient was airlifted to hospital. In four (10%) cases, the patient underwent prehospital anaesthesia. There were no specific predictors of HEMS intervention. Admission to a major trauma centre was associated with the rider not wearing a helmet, a fall onto their head or the horse falling onto the rider.
  
  
  CONCLUSIONS
  Equestrian accidents represent a significant proportion of HEMS missions. The majority of patients injured in equestrian accidents do not require HEMS intervention, however, a small proportion have life-threatening injuries, requiring immediate critical intervention. Further research is warranted, particularly regarding HEMS dispatch, to further improve accuracy of tasking to equestrian accidents.
authors.affiliation: aEmergency Medicine Research Group, Edinburgh bKent, Surrey & Sussex Air Ambulance Trust, Kent, UK.
authors.forename: Richard M
authors.initials: RM
authors.lastname: Lyon
authors.forename: Ben
authors.initials: B
authors.lastname: Macauley
authors.forename: Sarah
authors.initials: S
authors.lastname: Richardson
authors.forename: Richard
authors.initials: R
authors.lastname: de Coverly
authors.forename: Malcolm
authors.initials: M
authors.lastname: Russell
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D017732:Air Ambulances / Q000706:statistics & numerical data*; D000818:Animals; D001265:Athletic Injuries / Q000175:diagnosis* / Q000628:therapy*; D016208:Databases, Factual; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006736:Horses; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008297:Male; D018570:Risk Assessment; D013177:Sports; D006113:United Kingdom; D055815:Young Adult