Changes in the Helicopter Medical Service System of L'Aquila (Italy), After the Fatal Helicopter Crash on Monte Cefalone (January 24, 2017). A Retrospective Study

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Dec 17

PMID 39687185

Authors

Barbara Pizzi

Vincenza Cofini

Stefano Necozione

Andrea Fiora

Martina Mancinelli

Gino Bianchi

Emiliano Petrucci

Franco Marinangeli

Affiliations

Soon will be listed here.

Abstract

Introduction: The use of helicopter emergency medical services is useful for rescuing or transporting highly time-dependent disease patients, from urban remote areas or harsh environments in the hospital, providing advanced pre-hospital life support in an emergency setting.

Study Objective: This study aims to identify changes in mission characteristics, crew composition, and operational procedures within the helicopter emergency medical service (HEMS) system of L'Aquila, Italy, to identify operational patterns, mission characteristics, crew composition and patient outcomes over time, with specific attention to changes implemented after the Monte Cefalone incident.

Methods: Changes in the characteristics of the rescued patients, the helicopter missions, the crew members and the type of interventions were analysed. T-test or chi-square test were used to compare data before and after the incident.

Results: Three thousand three hundred and ninety-two records were reviewed. Following the crash, a pilot was added to the crew. Two hundred and thirteen missions were classified as cancelled: 47 before and 166 after the crash. The cancellations due to the lack of horizontal visibility were: 4 out of 47 (8.5 %) and 24 out of 166 (14.5). Most of the rescued victims had trauma: 45 % before and 50 % after the crash. The helicopter flights were prevalent in harsh environments. After the accident, the percentage of missions in harsh environment decreased from 80 % to 64 %. The type of rescue and operations changed significantly (p < 0.001). The proportion of hospitalized patients increased from 60 % to 93 % while the recorded deaths in place were similar (6 % vs 7 %). A decrease in the number of transport refusals, from 4 % to 0.4 %, was reported.

Conclusion: The results of our research highlighted that the helicopter emergency medical service of L'Aquila continued to fly in safety, for patient rescue and hospitalization despite being subjected to harsh conditions and environments, and despite the accident.

References

Tomazin I, Vegnuti M, Ellerton J, Reisten O, Sumann G, Kersnik J . Factors impacting on the activation and approach times of helicopter emergency medical services in four Alpine countries. Scand J Trauma Resusc Emerg Med. 2012; 20:56. PMC: 3503609. DOI: 10.1186/1757-7241-20-56. View

Gatterer H, Niedermeier M, Pocecco E, Fruhauf A, Faulhaber M, Menz V . Mortality in Different Mountain Sports Activities Primarily Practiced in the Summer Season-A Narrative Review. Int J Environ Res Public Health. 2019; 16(20). PMC: 6843304. DOI: 10.3390/ijerph16203920. View

Pietsch U, Knapp J, Mann M, Meuli L, Lischke V, Tissi M . Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland. Scand J Trauma Resusc Emerg Med. 2021; 29(1):92. PMC: 8276414. DOI: 10.1186/s13049-021-00898-y. View

Rzonca P, Swiezewski S, Jalali R, Gotlib J, Galazkowski R . Helicopter Emergency Medical Service (HEMS) Response in Rural Areas in Poland: Retrospective Study. Int J Environ Res Public Health. 2019; 16(9). PMC: 6539897. DOI: 10.3390/ijerph16091532. View

Erler C, Edwards N, Ritchey S, Pesut D, Sands L, Wu J . Perceived patient safety culture in a critical care transport program. Air Med J. 2013; 32(4):208-15. DOI: 10.1016/j.amj.2012.11.002. View

Wake K, Noguchi T, Hishinuma H, Zaitsu M, Kikuchi J, Uchida M . Characteristics of patients who received helicopter emergency medical services in Japan from 2012 to 2019: a retrospective analysis of data from Tochigi Prefecture. Scand J Trauma Resusc Emerg Med. 2022; 30(1):25. PMC: 8996593. DOI: 10.1186/s13049-022-01012-6. View

Li K, Li J, Li Y . The effects of social media usage on vicarious traumatization and the mediation role of recommendation systems usage and peer communication in China after the aircraft flight accident. Eur J Psychotraumatol. 2024; 15(1):2337509. PMC: 11022913. DOI: 10.1080/20008066.2024.2337509. View

Moens D, Stipulante S, Donneau A, Hartstein G, Pirotte O, DOrio V . Air versus ground transport of patients with acute myocardial infarction: experience in a rural-based helicopter medical service. Eur J Emerg Med. 2014; 22(4):273-8. DOI: 10.1097/MEJ.0000000000000149. View

Rikken Q, Mikdad S, Carvalho Mota M, de Leeuw M, Schober P, Schwarte L . Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?. Eur J Trauma Emerg Surg. 2021; 47(3):703-711. PMC: 7802610. DOI: 10.1007/s00068-020-01569-w. View

10.

Saviluoto A, Bjorkman J, Olkinuora A, Virkkunen I, Kirves H, Setala P . The first seven years of nationally organized helicopter emergency medical services in Finland - the data from quality registry. Scand J Trauma Resusc Emerg Med. 2020; 28(1):46. PMC: 7260827. DOI: 10.1186/s13049-020-00739-4. View

11.

Grimholt T, Bonsaksen T, Schou-Bredal I, Heir T, Lerdal A, Skogstad L . Flight Anxiety Reported from 1986 to 2015. Aerosp Med Hum Perform. 2019; 90(4):384-388. DOI: 10.3357/AMHP.5125.2019. View

12.

Reid B, Haugland H, Rehn M, Uleberg O, Kruger A . Search and Rescue and Remote Medical Evacuation in a Norwegian Setting: Comparison of Two Systems. Wilderness Environ Med. 2019; 30(2):155-162. DOI: 10.1016/j.wem.2019.02.003. View

13.

Hartmann K, Lubin J, Boehmer S, Amin S, Flamm A . Ground Versus Air: Which Mode of Emergency Medical Service Transportation Is More Likely to Crash?. Air Med J. 2023; 42(1):28-35. DOI: 10.1016/j.amj.2022.10.014. View

14.

Brumbach B, Figueredo A, Ellis B . Effects of Harsh and Unpredictable Environments in Adolescence on Development of Life History Strategies: A Longitudinal Test of an Evolutionary Model. Hum Nat. 2010; 20(1):25-51. PMC: 2903759. DOI: 10.1007/s12110-009-9059-3. View

15.

Bellini C, Gente M . Helicopter Emergency Medical Service in Italy: A 2021 Update. Air Med J. 2021; 40(6):419-426. DOI: 10.1016/j.amj.2021.08.002. View

16.

Swiezewski S, Rzonca P, Panczyk M, Leszczynski P, Gujski M, Michalak G . Polish Helicopter Emergency Medical Service (HEMS) Response to Stroke: A Five-Year Retrospective Study. Med Sci Monit. 2019; 25:6547-6553. PMC: 6738001. DOI: 10.12659/MSM.915759. View

17.

Wolthers S, Breindahl N, Walther Jensen T, Holgersen M, Moller T, Blomberg S . Prehospital interventions and outcomes in traumatic cardiac arrest: a population-based cohort study using the Danish Helicopter Emergency Medical Services data. Eur J Emerg Med. 2023; 31(5):324-331. PMC: 11356682. DOI: 10.1097/MEJ.0000000000001108. View

18.

Tase C, Ohno Y, Hasegawa A, Tsukada Y, Shimada J, Ikegami Y . Helicopter emergency medical services (doctor-helicopter) in Fukushima Prefecture: present state and problems. Fukushima J Med Sci. 2011; 56(1):71-9. DOI: 10.5387/fms.56.71. View

19.

Swiezewski S, Wejnarski A, Leszczynski P, Wojak A, Fronczak A, Darocha T . Characteristics of urban versus rural utilization of the Polish Helicopter Emergency Medical Service in patients with ST-segment elevation myocardial infarction. Kardiol Pol. 2020; 78(4):284-291. DOI: 10.33963/KP.15190. View

20.

Marinangeli F, Tomei M, Ursini M, Ricotti V, Varrassi G . Helicopter emergency medical service in Italy: reality and perspectives. Air Med J. 2007; 26(6):292-8. DOI: 10.1016/j.amj.2007.06.010. View