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，用于心血管急症患者的时间紧迫的跨设施转运

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) 将心血管急症危重患者从小型医院转移到主要医疗中心的持续时间。这项回顾性观察性队列研究包括瑞士最大的 HEMS 供应商在 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移 (IFT)。所有患有急性心肌梗塞、非创伤性中风、主动脉瘤破裂和其他疾病的患者包括急性血管急症。将每个 HEMS IFT 的持续时间和距离与使用地面运输 (GEMS) 的相同任务的计算距离和旅行持续时间进行比较。地面任务距离超过该距离后，HEMS 的总任务持续时间预计将比 GEMS 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) 而转院。从紧急呼叫到目的地着陆的总任务持续时间中位数为 59.9（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。专业化医疗服务的集中化应伴随着综合性、专业化的救援链。瑞士的 HEMS 确保在医疗紧急情况下具有时间敏感性的 IFT，即使是在地形具有挑战性的地形中。