Patient and mission characteristics of helicopter emergency medical services in the Republic of Ireland: a retrospective analysis

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The National Ambulance Service (NAS) has operated a Paramedic-staffed Helicopter Emergency Medical Services (HEMS) in the Republic of Ireland since 2012. This study describes patient and mission characteristics, to provide insight into this service and inform future service development. A nationwide population-based retrospective study of HEMS missions was conducted from routinely collected health data over an 11- year period between 1 July 2012 and 30 June 2023. In the study period HEMS in Ireland received 8,392 mission requests, Patient contact occurred in 60.1% of missions (n = 5,045) and 73.4% (n = 3703) were airlifted to hospital. Adults represented 90.3% (n = 4,535) of patients, predominantly male at 69.1%, with a median age of 55 years (IQR: 34 years) [35:69]. Medical patients accounted for 50.3% (n = 2,524), cardiac aetiologies (32.3%) and out of hospital cardiac arrest (OHCA) (30.3%) were the most common medical presentation. Trauma patients account for 49.7% (n = 2,498). Road Traffic Collisions (RTCs) (31.4%) followed by farming and machinery incidents (17.4%) were the most common trauma presentation. HEMS teams significantly reduced pain in both trauma (ꭕ2 = 680, p < .001) and medical cases (ꭕ2 = 186.13, p < .001) during the care provided. The majority 73.1% (n = 6133) of total missions were conducted within a 20 min flight time radius of the HEMS base. Over the past decade, HEMS in Ireland has provided a valuable contribution to the care of seriously ill and injured patients, particularly in the west and southwest. Service use reflects HEMS base proximity, indicating potential benefits from geographic expansion. Current activation criteria appears to target an appropriate patient cohort, however sustained reassessment of dispatch criteria and hours of operation may enhance service availability. Continued development should focus on adopting evidence based-practices and advancing critical care capacity to align with international HEMS standards. Numerous observational descriptive studies have outlined Helicopter Emergency Medical Service (HEMS) provision across the globe, to date none have described the mission profiles and the characteristics of the patients treated by HEMS in Ireland. This paper is the first to describe the mission and patient characteristics of a paramedic staffed HEMS in Western Europe, this study reflects on a decade of learning and opportunities for future growth in a time of major healthcare reforms in Ireland and centralisation of specialist care.

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