Nine golden codes: improving the accuracy of Helicopter Emergency Medical Services (HEMS) dispatch-a retrospective, multi-organisational study in the East of England

• Published in: Scandinavian journal of trauma, resuscitation and emergency medicine resuscitation and emergency medicine, 2023-06, Vol.31 (1), p.27-27, Article 27
• Main Authors: Edmunds, Christopher T, Lachowycz, Kate, McLachlan, Sarah, Downes, Andrew, Smith, Andrew, Major, Rob, Barnard, Edward B G
• Format: Article
• Language: English
• Subjects: Accuracy; Air ambulances; Clinical outcomes; Codes; Critical care; Emergency medical dispatch; Emergency medical services; Helicopter ambulances; Original Research; Paramedics; Patients; Prehospital emergency care; Quality management; Software; Statistics; Teams
• ISSN: 1757-7241; 1757-7241
• DOI: 10.1186/s13049-023-01094-w

Helicopter Emergency Medical Services (HEMS) are a limited and expensive resource, and should be intelligently tasked. HEMS dispatch was identified as a key research priority in 2011, with a call to identify a 'general set of criteria with the highest discriminating potential'. However, there have been no published data analyses in the past decade that specifically address this priority, and this priority has been reaffirmed in 2023. The objective of this study was to define the dispatch criteria available at the time of the initial emergency call with the greatest HEMS utility using a large, regional, multi-organizational dataset in the UK. This retrospective observational study utilized dispatch data from a regional emergency medical service (EMS) and three HEMS organisations in the East of England, 2016-2019. In a logistic regression model, Advanced Medical Priority Dispatch System (AMPDS) codes with ≥ 50 HEMS dispatches in the study period were compared with the remainder to identify codes with high-levels of HEMS patient contact and HEMS-level intervention/drug/diagnostic (HLIDD). The primary outcome was to identify AMPDS codes with a > 10% HEMS dispatch rate of all EMS taskings that would result in 10-20 high-utility HEMS dispatches per 24-h period in the East of England. Data were analysed in R, and are reported as number (percentage); significance was p  10% HEMS dispatch of all EMS taskings) resulted in 17 taskings per 24-h period. This definition derived nine AMPDS codes with high HEMS utility. We have identified nine 'golden' AMPDS codes, available at the time of initial emergency call, that are associated with high-levels of whole-system and HEMS utility in the East of England. We propose that UK EMS should consider immediate HEMS dispatch to these codes.