Physician-staffed HEMS dispatch in the Netherlands: Adequate deployment or minimal utilization?

Area of Science:

• Emergency Medicine
• Prehospital Care
• Medical Systems Analysis

Background:

• The Netherlands utilizes a physician-staffed Helicopter Emergency Medical System (HEMS), the Helicopter Mobile Medical Team (HMMT), for severe trauma cases.
• HEMS has demonstrated benefits in improving survival rates and reducing patient morbidity.

Purpose of the Study:

• To analyze the actual dispatch rates of the HMMT in Rotterdam.
• To assess emergency dispatcher adherence to established HMMT dispatch protocols.

Main Methods:

• Prospective documentation of all high-priority ambulance runs over a three-month period.
• Cross-referencing documented runs with HMMT dispatch criteria to evaluate protocol adherence.

Main Results:

• Out of 5765 ambulance runs, 1148 met primary and 38 met secondary HMMT dispatch criteria.
• Actual HMMT dispatch occurred in only 162 out of 1186 eligible cases (14% rate).

Conclusions:

• HEMS dispatch rates and protocol adherence by dispatchers are significantly low (14%).
• Enhanced adherence could potentially increase HMMT dispatches sevenfold.
• Reasons for persistent suboptimal adherence require further investigation despite HEMS's proven benefits.