The goal of improving quality through centralisation of specialised medical services must be balanced against potential harm caused by delayed access to emergency treatments in rural areas. This study aims to assess the duration of transfers of critically ill patients with cardiovascular emergencies from smaller hospitals to major medical centres by a helicopter emergency medical service (HEMS) in Switzerland. This retrospective observational cohort study includes all consecutive emergency interfacility transfers (IFTs) conducted by Switzerland’s largest HEMS provider between July 3rd, 2019, and March 31st, 2021. All patients with acute myocardial infarction, non-traumatic strokes, ruptured aortic aneurysms, and other acute vascular emergencies were included. The duration and distance of each HEMS IFT were compared to calculated distances and duration of travel for the same missions using ground-based transportation (GEMS). The ground-based mission distance beyond which the total mission duration of HEMS is expected to be faster than GEMS was calculated. A total of 645 patients were transferred for stroke (n = 364), myocardial infarction (n = 252) and other acute vascular emergencies (n = 29). The median total mission duration from emergency call to landing at the destination was 59.9 (IQR 51.5 to 70.5) minutes. The median road distance for the same missions was 60 (IQR 43 to 72) km. Regression analysis revealed that HEMS is expected to be faster if the road distance is more than 51.3 km. Centralisation of specialised medical services should be accompanied by a comprehensive and specialised rescue chain. HEMS in Switzerland ensures time-sensitive IFT in medical emergencies, even in topographically challenging terrain.

中文翻译：

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直升机紧急医疗服务，为心血管急症患者提供时间紧迫的设施间转运


通过集中专业医疗服务来提高质量的目标必须与农村地区因延迟获得紧急治疗而造成的潜在危害相平衡。本研究旨在评估瑞士直升机紧急医疗服务 (HEMS) 将患有心血管紧急情况的危重患者从小型医院转移到主要医疗中心的持续时间。这项回顾性观察队列研究包括瑞士最大的 HEMS 提供商在 2019 年 7 月 3 日至 2021 年 3 月 31 日期间进行的所有连续紧急设施间转运 (IFT)。所有患有急性心肌梗死、非创伤性中风、主动脉瘤破裂和其他疾病的患者急性血管急症也包括在内。将每个 HEMS IFT 的持续时间和距离与使用地面运输 (GEMS) 计算的相同任务的旅行距离和持续时间进行比较。计算了地面任务距离，超过该距离，HEMS 的总任务持续时间预计将比 GEMS 更快。共有 645 名患者因中风（n = 364）、心肌梗塞（n = 252）和其他急性血管急症（n = 29）而被转院。从紧急呼叫到降落在目的地的中位总任务持续时间为 59.9 分钟（IQR 51.5 至 70.5）分钟。相同任务的平均道路距离为 60（IQR 43 至 72）公里。回归分析显示，如果道路距离超过 51.3 公里，HEMS 预计会更快。集中专科医疗服务应配套完善、专业化的救援链条。瑞士的 HEMS 可确保在医疗紧急情况下及时响应 IFT，即使是在地形复杂的地形中也是如此。