Interhospital transportation of cardiac arrest patients by Helicopter Emergency Medical Service in a rural area

Introduction Out of hospital cardiac arrest is a major cause of death and disabilities worldwide. In rural provinces, medical resources are limited and the vast distance from the collapse site to a tertiary center with adequate facilities could result in an increase in preventable deaths. This study intends to study the implications and demographics of Helicopter Emergency Medical Service for interhospital transfer of patients in the region of Gangwon-do and neighbouring regions. Material & Method The study was a retrospective observational study and included both OHCA and IHCA(in previous hospital) patients transported by HEMS from other hospitals to Wonju Severance Christian Hospital during the period from June 2013 to August 2020. The characteristics of cardiac arrest, interventions during transport, ROSC state, time from HEMS activation to scene and collapse to HEMS arrival, survival and cerebral performance category of patients were investigated. Result A significant portion of cardiac arrest patients were transported by HEMS. Etiologies of cardiac arrest varied and the most common etiology was non-cardiac. Most patients transported by HEMS achieved ROSC before transport. Cardiac arrest patients with shockable rhythm were more likely to survive and had favorable CPC score. Interventions during HEMS transport included cardiopulmonary resuscitation, defibrillation and epinephrine administration. Patients with initial asystole, PEA rhythm had poor outcomes. Conclusion Transport of critically ill patients such as cardiac arrest patients represent a significant proportion of HEMS activations. Post ROSC OHCA patients are most commonly transported and patients with cardiac origin of arrest had a trend towards better survival and neurological outcomes. Faster interhospital transfers by air and the presence of an EM board certified physician suggests better patient outcome trends.