Page 44 - JSOM Fall 2025

TABLE 3 Procedures Performed by the Medical Team saved these lives, their measured vital signs and clinical condition
No. of Percentage on arrival suggest that the absence of the medical intervention
Procedure patients (95% CI) could have resulted in death. While no directly comparable stud-
Primary hemostasis ies exist analyzing patient severity in SAR missions, we can com-
No 171 97.7 (96–99.7) pare these results with three other European studies (Table 5).
Yes 4 2.3 (0.6–4.2)
TABLE 4 Calculating Response Time
Tranexamic acid No. of
No 172 98.3 (97.1–100) analyzable Average time Median time
Yes 3 1.7 (0.6–3.7) Time interventions (95% CI), min (25/75quartile), min
Fluids (volume expansion) A/T time 59 49.8 (42.9–56.7) 43 (28.5–69.0)
No 98 56.0 (48.6–63.5) A/A time 53 79.5 (69.0–90.1) 69 (48.0–107.0)
Yes 77 44.0 (36.6–51.5) A/A = activation to arrival at the casualty’s location; A/T = activation
to the helicopter’s take-off
Amines
No 163 93.1 (90.3–97.0) TABLE 5 Comparison of Data from Different European Studies
Yes 12 6.9 (4.0–10.7) Study; % of patients*
Transfusion
This Swiss Norwegian HéliSMUR
No 174 99.4 (98.9–100) Characteristic study study study study
Yes 1 0.6 (0.0–1.5) Patients in 34.9 27 33.3 8
Lyophilized plasma imminent danger
No 175 100 (100–100) Traumatic 19 91 30 8
pathology
Antiplatelet / anticoagulant
Cardiovascular
No 160 91.4 (88.0–95.6) pathology 13 29 20
Yes 15 8.6 (5.1–12.7) Neurological 14 9 15 5
Cardiopulmonary resuscitation pathology
No 166 94.9 (92–97.7) Respiratory 6 5 No data
pathology
Yes 9 5.1 (2.3–8.0)
Drowning 11 0 No data No data
Thrombolysis Disappearance
No 173 98.9 (97.7–100.0) or crash 12 No data 2 No data
Yes 2 1.1 (0.0–2.3) Secondary 16 No data No data 80
Oxygen transport
No 145 82.9 (77.7–88.4) Flight refusal 0 No data 22.4 14.7
Yes 30 17.1 (12.0–22.7) Average take-off 50 7 29 No data
time, min
Needle decompression *Unless otherwise specified.
No 174 99.4 (98.9–100.0)
Yes 1 0.6 (0.0–1.5) In a Swiss study by Pasquier et al., 91% of missions were
4
Orotracheal intubation triggered by traumatic pathology, and 27% of patient condi-
No 165 94.3 (91.4–97.6) tions were considered life-threatening. Patients suffering from
Yes 10 5.7 (2.9–9.0) non-traumatic pathology appeared to be significantly more
Intraosseous catheter serious (P<.001), as in our study.
No 170 97.1 (95.4–99.6) A Norwegian study by Osteras et al. found that 33% of pa-
5
Yes 5 2.9 (1.1–5.3) tients were considered serious, often due to hypothermia. In
Immobilization rural areas of Norway, response times are considerably longer;
No 164 93.7 (90.9–97.3) isolated and difficult landing areas could explain the similari-
Yes 11 6.3 (3.4–9.9) ties to our results.
Pelvic belt Finally, in the single-site HéliSMUR 84 study by Zagula of a ru-
No 174 99.4 (98.9–100) ral inland region of France called Vaucluse, the mortality prob-
6
Yes 1 0.6 (0.0–1.5) ability was calculated at 8%. Most missions were non-emergent
Osmotherapy patient transfers, unlike SAR missions. The seriousness of SAR
No 173 98.9 (97.7–100) patients can be explained by the difference between the heli-
Yes 2 1.1 (0.0–2.3) copters used. HéliSMUR helicopters have an exclusively med-
Level 3 analgesics ical role and are primarily used to reduce response time. They
No 142 81.1 (76.0–87.1) have no winching capability or night vision binoculars and have
difficulty landing in the mountains or intervening at sea. This
Yes 33 18.9 (13.7–24.9) explains why they are used with less serious patient conditions.
Antibiotic therapy
No 166 94.9 (92–97.7) The Norwegian and Swiss investigations reveal that in envi-
Yes 9 5.1 (2.3–8.0) ronments with challenging weather or terrain with difficult

42 | JSOM Volume 25, Edition 3 / Fall 2025