An international survey on medical crew models in HEMS has sought to consider the influence that the types of crewmembers onboard helicopters providing emergency medical services has on the safety of the aircraft and its crew. According to the survey, which was published in the most recent edition of the Air Medical Journal, ‘the competence, composition, and number of crewmembers have generally been considered to influence the degree of patient care and safety in helicopter emergency medical services (HEMS), but evidence to support the advantages of one crew concept over another is ambiguous; additionally, the benefit of physicians as crewmembers is still highly debated’.
To compare perceived safety in different medical crew models, the team surveyed international HEMS medical directors regarding the types of crew compositions their system currently used and their supportive rationales and to evaluate patient and flight safety within their services. The results showed a wide variety of medical staffing models in HEMS, and indicated that these differences are mainly related to medical competencies and the availability of an assistant in the medical cabin. “The responses,” noted the study authors, “suggest that differences in medical staffing influence perceived flight and patient safety.”
The authors concluded: “The competence, composition, and number of crewmembers may play a role in creating adequate redundancy in patient care to ensure patient safety, but supportive documentation regarding one crew configuration over another has thus far proven inconclusive. The benefit of including physicians in HEMS is highly debated. Some studies have found that HEMS physicians contribute to improved survival, whereas other studies showed no difference. In trauma patients who were transported either with the combination of a flight nurse and a flight paramedic or with two flight nurses, the outcomes were also indistinguishable. It has been suggested that it is the training and not the profession that is essential.”
The aim of this study was to describe the diversity of medical crew compositions currently used in HEMS and supportive rationales of these decisions. The hypothesis drawn by the study is that the medical crew composition influences perceived patient and flight safety as reported by medical directors representing HEMS systems using different medical crew models.
The authors of the study were Dr Kristen Rasmussen, Dr Jo Roislien and Dr Stephen Sollid, all of whom are members of the Department of Research and Development for The Norwegian Air Ambulance Foundation.