Difficult aeromedical rescue situations: experience of a Swiss pre-alpine helicopter base

Swiss Air Rescue (REGA) teams execute more than 3000 aeromedical missions annually, of which some require the use of a winch. To evaluate the need for early medical intervention at sites where landing is impossible, we analyzed retrospectively 100 consecutive operations (10.8% of all primary missions, 110 patients) accomplished by the REGA base at Lausanne with an emergency physician of the Centre Hospitalier Universitaire Vaudois (CHUV) on board. In such difficult rescue conditions, time to call, response times, and scene times were particularly long (mean delay to admission: 114 minutes). Fourteen patients were dead on arrival, 22 were uninjured, 50 had NACA Index 1-3 injuries (moderate), 22 had NACA Index 4-6 injuries (severe). Seventeen required major intervention at the site or during rescue. We conclude that in our European pre-alpine region 22% of patients rescued by winch are severely injured. Since rescue actions are particularly long and difficult, the performance of advanced procedures at the scene and during transportation is of great value.