Characteristics of Patients Treated by Helicopter Emergency Medical Services Globally: A Scoping Review

Helicopter emergency medical services (HEMS) are used to deliver advanced care in time-critical and remote settings; however, the characteristics of patients attended during primary missions are not well described. This scoping review aimed to characterize the demographics and clinical features of patients treated during primary HEMS responses worldwide and describe crew composition and critical care interventions.

This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A literature search was conducted in Ovid MEDLINE, Embase, Scopus, CINAHL, and the Cochrane Library. Gray literature was searched through TROVE. Studies describing patients attended during primary HEMS missions were included.

Thirty-three retrospective observational studies were included. Patients were predominantly male, trauma was the most common presentation, and patient acuity was frequently high. Crew composition varied by region, with physician-paramedic models most commonly reported. Reporting of critical care interventions was inconsistent. Among reported interventions, endotracheal intubation was most frequently described, whereas surgical procedures were rare.

Primary HEMS missions involve heterogeneous patient populations but consistently include a substantial proportion of high-acuity cases. Heterogeneity in reporting and definitions of clinical interventions limits comparison between systems. Improved standardization of reporting is required to support service planning, evaluation, and benchmarking and to facilitate future comparative research.