I bring you a weekly bite-sized chunk of the science behind helicopter human factors and CRM in practice, simplifying the complex and distilling a helicopter related study into a summary of less than 500 words.
TITLE:
Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: analysis of 11,228 daytime and nighttime missions in Switzerland.
WHAT?
A retrospective study analysing 11,228 helicopter hoist operations (HHO) and human external cargo (HEC) missions to understand the operational and medical challenges of hoist operations, with particular focus on aspects such as night missions, injury severity, and crew task demands.
WHERE?
Based on data from Swiss Air-Rescue (Rega), which operates across alpine, remote, and urban environments in Switzerland.
WHEN?
Published 2021. Missions analysed conducted between January 2010 and December 2019.
WHY?
Hoist operations, enabling on-scene care and safe patient evacuation, are used when helicopters cannot land due to terrain (e.g., alpine or remote environments). The study aimed to investigate injury severity and types of medical care required during these missions, and assess how nighttime operations compare with daytime.
HOW?
Researchers used Rega’s electronic medical record system to identify 11,228 HHO and HEC missions. They analysed mission characteristics, injury severity, types of medical interventions performed, and differences between day and night missions.
FINDINGS:
- Hoist missions routinely required crews to manage simultaneous aviation, technical, and medical tasks, often in austere environments.
- Almost 20 % of patients evacuated by hoist were severely injured, or required complex or lifesaving medical interventions before the HHO procedure.
- 4/5 of patients evacuated by hoist had minor injuries of were uninjured.
- The number of hoisting tasks increased over the ten year period studied.
- Higher injury severity, trauma cases, and cases requiring on-scene intubation were all associated with longer mission times.
- Only 11.3 % of missions occurred at night, but these missions were also disproportionately complex and time-consuming.
- Consequently, fewer patients reached hospital within 60 minutes at night, reflecting night operating challenges and increased coordination demands.
SO WHAT?
The data underline that hoist operations are not merely technical evolutions but involve complex socio-technical dynamics, where experience, team familiarity, and organisational support are essential to managing risk, particularly at night.
Crews should anticipate that night hoist operations and missions involving serious injuries will take longer and should plan accordingly.
Night hoist missions amplify risks related to reduced visual cues, spatial disorientation, workload, and time pressure, increasing the importance of non-technical skills, such as crew coordination, communication, shared situational awareness, and decision-making.
From a training and operations perspective, the study supports dedicated hoist-qualified crews, robust SOPs, and team-based training that integrates pilots, technical crew members, and medical staff.
REFERENCE:
Pietsch, U., Knapp, J., Mann, M., Meuli, L., Lischke, V., Tissi, M., Sollid, S., Rauch, S., Wenzel, V., Becker, S., & Albrecht, R. (2021). Incidence and challenges of helicopter emergency medical service (HEMS) rescue missions with helicopter hoist operations: Analysis of 11,228 daytime and nighttime missions in Switzerland. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 29(92). https://doi.org/10.1186/s13049-021-00898-y
competentaviators.com 