title: A Paramedic-staffed Helicopter Emergency Medical Service's Response to Winch Missions in Victoria, Australia.
abstract: Winching emergency medical care providers from a helicopter to the scene enables treatment of patients in otherwise inaccessible locations, but is not without risks. The objective of this study was to define characteristics of winch missions undertaken by Intensive Care Flight Paramedics (ICFP) in Victoria, Australia with a focus on extraction methods and clinical care delivered at the scene. A retrospective data analysis was performed to identify all winch missions between November 2010 and March 2014. Demographic data, winch characteristics, physiological parameters, and interventions undertaken on scene by the ICFP were extracted. Out of 5,003 missions in the study period, 125 were identified as winch operations. Winter missions were significantly less frequent than those of any other season. Patients were predominantly male (78.4%) and had a mean age of 38 years (±17.6). A total of 109 (87.2%) patients were identified as experiencing trauma with a mean Revised Trauma Score of 7.5288, and isolated limb fractures were the most frequently encountered injury. Falls and vehicle-related trauma were the most common mechanisms of injury. The total median scene duration was 49 minutes (IQR 23-91). Sixty-three patients (50.4%) were extracted using a stretcher, 45 (36.0%) using a hypothermic strop, and 6 (4.8%) via normal rescue strop. Eleven patients (8.8%) were not winched to the helicopter. Vascular access (38.4%), analgesia (44.0%), and anti-emetic administration (28.8%) were the most frequent clinical interventions. Forty-nine patients (39.2%) did not receive any clinical intervention prior to winch extraction. Winch operations in Victoria, Australia consisted predominantly of patients with minor to moderate traumatic injuries. A significant proportion of patients did not require any clinical treatment prior to winching, and among those who did, analgesia was the most frequent intervention. Advanced medical procedures were rarely required prior to winch extraction.
authors.forename: Ben
authors.initials: B
authors.lastname: Meadley
authors.forename: Stefan
authors.initials: S
authors.lastname: Heschl
authors.forename: Emily
authors.initials: E
authors.lastname: Andrew
authors.forename: Anthony
authors.initials: A
authors.lastname: de Wit
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Bernard
authors.forename: Karen
authors.initials: K
authors.lastname: Smith
mesh_terms: D000328:Adult; D017732:Air Ambulances; D000401:Aircraft; D000488:Allied Health Personnel; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D018635:Rescue Work; D012189:Retrospective Studies; D012621:Seasons; D015599:Trauma Severity Indices; D014739:Victoria; D000078329:Workforce
keywords: aerial rescue; helicopter emergency medical system; hoist; prehospital care; winch