title: Cross-sectional investigation of HEMS activities in Europe: a feasibility study.
abstract: OBJECTIVE
  To gather information on helicopter emergency medical services (HEMSs) activities across Europe.
  
  
  METHODS
  Cross-sectional data-collection on daily (15 November 2013) activities of a sample of European HEMSs. A web-based questionnaire with both open and closed questions was used, developed by experts of the European Prehospital Research Alliance (EUPHOREA).
  
  
  RESULTS
  We invited 143 bases from 11 countries; 85 (60%) reported base characteristics only and 73 (51%) sample-day data too. The variety of base characteristics was enormous; that is, the target population ranged from 94.000 to 4.500.000. Of 158 requested primary missions, 62 (0.82 per base) resulted in landing. Cardiac aetiology (36%) and trauma (36%) prevailed, mostly of life-threatening severity (43%, 0.64 per mission). Had HEMS been not dispatched, patients would have been attended by another physician in 67% of cases, by paramedics in 24%, and by nurses in 9%. On-board physicians estimated to have caused a major decrease of death risk in 47% of missions, possible decrease in 22%, minor benefit in 17%, no benefit in 11%, and damage in 3%. Earlier treatment and faster transport to hospital were the main reasons for benefit. The most frequent therapeutic procedure was drug administration (78% of missions); endotracheal intubation occurred in 25% of missions and was an option hardly offered by ground crews.
  
  
  CONCLUSIONS
  The study proved feasible, establishing an embryonic network of European HEMS. The participation rate was low and limits the generalizability of the results. Fortunately, because of its cross-sectional characteristics and the handy availability of the web platform, the study is easily repeatable with an enhanced network.
authors.affiliation: Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, P.O. Box 94, 1441 Drøbak, Norway ; Azienda Ospedaliero Universitaria di Udine, Piazza SM Misericordia 15, 33100 Udine, Italy.
authors.forename: Stefano
authors.identifier: 0000-0002-3468-9358
authors.initials: S
authors.lastname: Di Bartolomeo
authors.affiliation: Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, P.O. Box 94, 1441 Drøbak, Norway.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gava
authors.affiliation: Department of Anesthesiology and Intensive Care, Charles University in Prague, Faculty of Medicine in Hradec Kralove, University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic.
authors.forename: Anatolij
authors.initials: A
authors.lastname: Truhlář
authors.affiliation: Air Ambulance Department, Division of Emergencies and Critical Care, Oslo University Hospital, Sykehusveien 19, 1474 Nordbyhagen, Norway.
authors.forename: Mårten
authors.initials: M
authors.lastname: Sandberg
authors.affiliation: Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, P.O. Box 94, 1441 Drøbak, Norway.
mesh_terms: D017732:Air Ambulances / Q000458:organization & administration* / Q000600:supply & distribution*; D002318:Cardiovascular Diseases; D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries