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Added medical value of a helicopter-transported medical team on emergency prehospital pediatric care in The Netherlands


The aim of this study was to evaluate the effect of a helicopter-transported medical team (HMT) on the prehospital treatment of vitally compromised children. The study was performed in a Dutch HMT that provides advanced medical care in the eastern part of The Netherlands. The HMT consists of a specially trained physician and paramedic transported to the incident location by helicopter in the day-time. The Dutch HMT is activated together with the emergency medical service (EMS) by the dispatch centre or by the EMS paramedics at the incident location. Activation is according to a structured list of incident situations and/or the medical condition of the patient.


Retrospective analysis of 297 HMT calls for prehospital vitally comprised children (<16 years) from 2001 to 2005 by the HMT-Netherlands-East. Registered data included age, sex, physiological parameters and medical treatment. Specified was whether the medical procedures performed outside the hospital were provided by the EMS paramedic or the HMT physician; in all cases, EMS paramedics arrived at the incident location first. Medical procedures in children were classified into three groups: restricted to physician by Dutch law, physician more experienced than EMS paramedic, physician and EMS paramedic as experienced as each other. SPSS was used for descriptive analysis.


The EMS on scene canceled the pediatric HMT calls before the landing of the helicopter in 36% (n = 107) – reasons: no serious injury 82% (n = 88), deceased 10% (n = 11), other 8% (n = 8).

The HMT examined and treated 190 children on scene, with a total of 1461 medical procedures provided by the HMT physician (mean 7.7, SD 3.9). Medical procedures restricted to HMT physicians were given to 71% (n = 135) of the children (e.g. general anesthesia, thoracosynthesis, central venous cannulation). Medical procedures when classified as the HMT physician more experienced than the EMS paramedic were given to 76% (n = 144) of the children (e.g. endotracheal intubation, intra-osseous infusion, pain management). The combination of these two groups constituted 84% (n = 158) of all children examined by the HMT.


The Dutch-HMT provides crucial additional medical expertise not provided by the EMS paramedics. Eighty-four percent of the vitally compromised children received a prehospital medical procedure restricted to a physician or for which a physician was more experienced.

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Gerritse, B., Schalkwijk, A. & Draaisma, J. Added medical value of a helicopter-transported medical team on emergency prehospital pediatric care in The Netherlands. Crit Care 10 (Suppl 1), P131 (2006).

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