Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin
Dublin Core
Title
Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin
Subject
Loss of consciousness, Dispatch, Helicopter emergency medical service
Description
Background: Sudden loss of consciousness (LOC) in the prehospital setting in the absence of cardiac arrest and
seizure activity may be a challenge from a dispatcher’s perspective: The aetiology is varied, with many causes being
transient and mostly self-limiting, whereas other causes are potentially life threatening. In this study we aim to
evaluate the dispatch of HEMS to patients with LOC of medical origin, by exploring to which patients with a LOC
HEMS is dispatched, which interventions HEMS teams perform in these patients, and whether HEMS interventions
can be predicted by patient characteristics.
Methods: We performed retrospective cohort study of all patients with a reported unexplained LOC (e.g. not
attributable to a circulatory arrest or seizures) attended by the Air Ambulance Kent, Surrey & Sussex (AAKSS), over a
4-year period (July 2013–December 2017). Primary outcome was defined as the number of HEMS-specific
interventions performed in patients with unexplained LOC. Secondary outcome was the relation of clinical- and
dispatch criteria with HEMS interventions being performed.
Results: During the study period, 127 patients with unexplained LOC were attended by HEMS. HEMS was
dispatched directly to 25.2% of the patients, but mostly (74.8%) on request of the ground ambulance crews. HEMS
interventions were performed in 65% of the patients (Prehospital Emergency Anaesthesia 56%, hyperosmolar
therapy 21%, antibiotic/antiviral therapy 8%, vasopressor therapy 6%) and HEMS conveyed most patients (77%) to
hospital. Acute neurological pathology was a prevalent underlying cause of unexplained LOC: 38% had gross
pathology on their CT-scan upon arrival in hospital. Both GCS (r = − 0.60, p < .001) and SBP (r = 0.31, p < .001) were
related to HEMS interventions being performed on scene. A GCS < 13 predicted the need for HEMS interventions in
our population with a sensitivity of 94.9% and a specificity 75% (AUC 0.85)
seizure activity may be a challenge from a dispatcher’s perspective: The aetiology is varied, with many causes being
transient and mostly self-limiting, whereas other causes are potentially life threatening. In this study we aim to
evaluate the dispatch of HEMS to patients with LOC of medical origin, by exploring to which patients with a LOC
HEMS is dispatched, which interventions HEMS teams perform in these patients, and whether HEMS interventions
can be predicted by patient characteristics.
Methods: We performed retrospective cohort study of all patients with a reported unexplained LOC (e.g. not
attributable to a circulatory arrest or seizures) attended by the Air Ambulance Kent, Surrey & Sussex (AAKSS), over a
4-year period (July 2013–December 2017). Primary outcome was defined as the number of HEMS-specific
interventions performed in patients with unexplained LOC. Secondary outcome was the relation of clinical- and
dispatch criteria with HEMS interventions being performed.
Results: During the study period, 127 patients with unexplained LOC were attended by HEMS. HEMS was
dispatched directly to 25.2% of the patients, but mostly (74.8%) on request of the ground ambulance crews. HEMS
interventions were performed in 65% of the patients (Prehospital Emergency Anaesthesia 56%, hyperosmolar
therapy 21%, antibiotic/antiviral therapy 8%, vasopressor therapy 6%) and HEMS conveyed most patients (77%) to
hospital. Acute neurological pathology was a prevalent underlying cause of unexplained LOC: 38% had gross
pathology on their CT-scan upon arrival in hospital. Both GCS (r = − 0.60, p < .001) and SBP (r = 0.31, p < .001) were
related to HEMS interventions being performed on scene. A GCS < 13 predicted the need for HEMS interventions in
our population with a sensitivity of 94.9% and a specificity 75% (AUC 0.85)
Creator
J. Mohindru, J. E. Griggs, R. de Coverly, R. M. Lyon, E. ter Avest and on behalf of Air Ambulance Trust Kent Surrey Sussex
Publisher
BMC Emergency Medicine
Date
(2020) 20:92
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
J. Mohindru, J. E. Griggs, R. de Coverly, R. M. Lyon, E. ter Avest and on behalf of Air Ambulance Trust Kent Surrey Sussex, “Dispatch of a helicopter emergency medicine service to patients with a sudden, unexplained loss of consciousness of medical origin,” Repository Horizon University Indonesia, accessed February 5, 2025, https://repository.horizon.ac.id/items/show/3582.