Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest (OHCA) in the United States

Aditya C Shekhar; Michael Auten; Ethan E Abbott; Michael McCartin; Ira J Blumen

doi:10.1016/j.resplu.2024.100658

Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest (OHCA) in the United States

Resusc Plus. 2024 May 11:18:100658. doi: 10.1016/j.resplu.2024.100658. eCollection 2024 Jun.

Authors

Aditya C Shekhar¹, Michael Auten¹, Ethan E Abbott¹, Michael McCartin^{2

3}, Ira J Blumen^{2

3}

Affiliations

¹ Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
² Section of Emergency Medicine, University of Chicago Medicine, Chicago, IL, USA.
³ University of Chicago Aeromedical Network (UCAN), Chicago, IL, USA.

Abstract

Introduction: Helicopter emergency medical services (HEMS) are used in the United States and globally to respond to patients with critical illness and victims of traumatic injury. Relatively limited research has examined their role in responding to out-of-hospital cardiac arrests (OHCA) in the United States. In this study, we compared OHCA treated by HEMS units with cardiac arrests treated by ground ambulances.

Methods: We queried a large national-level database of emergency medical services (EMS) activations in the United States (NEMSIS). Inclusion criteria were OHCA activations between January 1, 2022 and December 31, 2022 treated by either HEMS or ground ambulance. Key arrest data from both groups were then compared. Interfacility transfers and cardiac arrests after EMS arrival were excluded.

Results: A total of 1,233 cardiac arrests treated by HEMS and 341,096 cardiac arrests treated by ground ambulances met inclusion criteria. Comparing the two groups, cardiac arrests with HEMS response were more likely to be male (66.7% vs. 62.8%, p < 0.01), White (50.2% vs. 45.7%, p < 0.01), under 18 years old (10.9% vs. 2.7%, p < 0.001), associated with traumatic injury (19.1% vs. 5.7%, p < 0.001), witnessed (72.7% vs. 37.3%, p < 0.001), and initially-shockable (24.7% vs. 11.1%, p < 0.001).

Conclusion: Our comparison of cardiac arrests treated by HEMS with cardiac arrests treated by ground ambulance reveals significant differences between the two groups. Further research is needed to better characterize HEMS' ideal role in the response to OHCA as new prehospital resuscitative techniques for non-traumatic and traumatic cardiac arrest are developed.

Keywords: Cardiac arrest; Emergency medical services; HEMS; Helicopter air ambulance; Helicopter emergency medical services; Out-of-hospital; Prehospital care; Sudden cardiac death.