High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021

Abstract Background Mountain sport activities are being practiced by an increasing number of people: The number of tourists visiting altitudes greater than 2,500 m above sea level in the Alps has been estimated at around 40 million people per year. For this reason, however, the number of emergencies...

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Main Authors: Eva Klocker, Lea Wienandts, Dario Josi, Simon Rauch, Roland Albrecht, Jürgen Knapp, Urs Pietsch
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Online Access:https://doi.org/10.1186/s13049-025-01419-x
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author Eva Klocker
Lea Wienandts
Dario Josi
Simon Rauch
Roland Albrecht
Jürgen Knapp
Urs Pietsch
author_facet Eva Klocker
Lea Wienandts
Dario Josi
Simon Rauch
Roland Albrecht
Jürgen Knapp
Urs Pietsch
author_sort Eva Klocker
collection DOAJ
description Abstract Background Mountain sport activities are being practiced by an increasing number of people: The number of tourists visiting altitudes greater than 2,500 m above sea level in the Alps has been estimated at around 40 million people per year. For this reason, however, the number of emergencies in remote areas, which can be reached most rapidly by helicopter, has also increased. Methods We retrospectively reviewed all rescue missions conducted by the Swiss Air Ambulance (Rega) in the period 2011–2021 that were carried out at an altitude of more than 2,500 m above sea level. Demographic and epidemiological data, medical measures implemented on scene, and the on-scene time were then analyzed for both trauma and non-trauma patients. Patients were categorized based on the National Advisory Committee for Aeronautics (NACA) score into non-injured (NACA 0), minor injured (NACA 0–3), seriously injured (NACA 4–6), deceased during mission (NACA 7), and already deceased on arrival of the HEMS team. Results A total of 3,564 rescue missions were analyzed. Of the patients, 66.8% were male and the vast majority (88.4%) were adults. In terms of injury level, 88.1% of the patients were minor injured, with an NACA score of 0–3, while 9.4% were seriously injured, with a score of 4–6. Patients who died in scene (NACA 7) accounted for 2.5% of cases. We observed a significant increase in the number of minor injured patients with traumatic injuries over the period of observation. Factors that significantly influenced the on-scene time included the NACA score, hoist missions, and traumatic injuries in summer. Conclusion Over the last ten years, the number of HEMS missions conducted at more than 2,500 m above sea level with non-injured and slightly injured patients has increased. The large number of HEMS missions with uninjured patients are of a preventive nature. Only around 9% of all rescue missions involved the medical treatment and rescue of seriously injured patients who required advanced medical interventions. Trial registration Ethics approval and consent to participate BASEC Nr. Req202200189.
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spelling doaj-art-098e35b8deb3489ebda9cf270beab31c2025-08-20T03:16:51ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412025-05-0133111010.1186/s13049-025-01419-xHigh-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021Eva Klocker0Lea Wienandts1Dario Josi2Simon Rauch3Roland Albrecht4Jürgen Knapp5Urs Pietsch6Department of Anaesthesiology, Rescue and Pain Medicine, HOCH Health Ostschweiz St. GallenDepartment of Internal Medicine, HOCH Health Ostschweiz AltstaettenAquatic Ecology and Evolution, Institute of Ecology and Evolution, University of BernDepartment of Anaesthesia and Intensive Care Medicine, Hospital MeranoSwiss Air Ambulance (Rega)University Clinic for Anaesthesiology and Pain Medicine, University Hospital BernSwiss Air Ambulance (Rega)Abstract Background Mountain sport activities are being practiced by an increasing number of people: The number of tourists visiting altitudes greater than 2,500 m above sea level in the Alps has been estimated at around 40 million people per year. For this reason, however, the number of emergencies in remote areas, which can be reached most rapidly by helicopter, has also increased. Methods We retrospectively reviewed all rescue missions conducted by the Swiss Air Ambulance (Rega) in the period 2011–2021 that were carried out at an altitude of more than 2,500 m above sea level. Demographic and epidemiological data, medical measures implemented on scene, and the on-scene time were then analyzed for both trauma and non-trauma patients. Patients were categorized based on the National Advisory Committee for Aeronautics (NACA) score into non-injured (NACA 0), minor injured (NACA 0–3), seriously injured (NACA 4–6), deceased during mission (NACA 7), and already deceased on arrival of the HEMS team. Results A total of 3,564 rescue missions were analyzed. Of the patients, 66.8% were male and the vast majority (88.4%) were adults. In terms of injury level, 88.1% of the patients were minor injured, with an NACA score of 0–3, while 9.4% were seriously injured, with a score of 4–6. Patients who died in scene (NACA 7) accounted for 2.5% of cases. We observed a significant increase in the number of minor injured patients with traumatic injuries over the period of observation. Factors that significantly influenced the on-scene time included the NACA score, hoist missions, and traumatic injuries in summer. Conclusion Over the last ten years, the number of HEMS missions conducted at more than 2,500 m above sea level with non-injured and slightly injured patients has increased. The large number of HEMS missions with uninjured patients are of a preventive nature. Only around 9% of all rescue missions involved the medical treatment and rescue of seriously injured patients who required advanced medical interventions. Trial registration Ethics approval and consent to participate BASEC Nr. Req202200189.https://doi.org/10.1186/s13049-025-01419-xHEMSHigh altitudeMountain medicineAlpine rescueOn-scene time
spellingShingle Eva Klocker
Lea Wienandts
Dario Josi
Simon Rauch
Roland Albrecht
Jürgen Knapp
Urs Pietsch
High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
HEMS
High altitude
Mountain medicine
Alpine rescue
On-scene time
title High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
title_full High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
title_fullStr High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
title_full_unstemmed High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
title_short High-altitude HEMS missions—a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021
title_sort high altitude hems missions a retrospective analysis of 3 564 air rescue missions conducted between 2011 and 2021
topic HEMS
High altitude
Mountain medicine
Alpine rescue
On-scene time
url https://doi.org/10.1186/s13049-025-01419-x
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