The helicopter as a caring context: Experiences of people suffering trauma

doi:10.1016/j.ienj.2016.09.006

International Emergency Nursing

Volume 32, May 2017, Pages 34-38

https://doi.org/10.1016/j.ienj.2016.09.006 Get rights and content

Highlights

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The mixed feelings of shock and curiosity related to being in a helicopter.
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The caregivers in HEMS provided comfort by showing consideration and being present.
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HEMS were highly valued and seen as the ‘best way’ to get to a hospital.

Abstract

Introduction

When emergency medical services (EMS) are needed, the choice of transport depends on several factors. These may include the patient’s medical condition, transport accessibility to the accident site and the receiving hospital’s resources. Emergency care research is advancing, but little is known about the patient’s perspective of helicopter emergency medical services (HEMS).

Aim

The aim of this study was to describe trauma patients’ experiences of HEMS.

Method

Thirteen persons (ages 21–76) were interviewed using an interview guide. Data were analyzed using qualitative content analysis.

Findings

The analysis resulted in three themes: Being distraught and dazed by the event – patients experienced shock and tension, as well as feelings of curiosity and excitement. Being comforted by the caregivers – as the caregivers were present and attentive, they had no need for relatives in the helicopter. Being safe in a restricted environment – the participants’ injuries were taken seriously and the caregivers displayed effective teamwork.

Conclusion

For trauma patients to be taken seriously and treated as ‘worst cases’ enables them to trust their caregivers and ‘hand themselves over’ to their care. HEMS provide additional advantageous circumstances, such as being the sole patient and having proximity to a small, professional team.

Introduction

Suffering a trauma results in a sudden change to one’s everyday life and, initially, not knowing the extent of one’s injuries [21]. Injury due to trauma may require emergency medical services (EMS) to assist in transferring the victim from the pre-hospital location to a hospital, as he or she may require specialist care and specific medical technology [7]. EMS-assisted transfers are done mostly with help from ground ambulances [34], but centralization of highly specialized care is expected to increase the need for airborne transport [33]. However, patients’ experiences of helicopter emergency medical services (HEMS) are rarely studied.

Section snippets

Background

Sweden has approximately 700 ground ambulances [31] and 9 ambulance helicopters [30]. There are three priority levels for alerting EMS: acute life-threatening symptoms or an accident; urgent but not life-threatening symptoms; other assignments for care or supervision needs where a reasonable period is not expected to affect a patient’s condition [32]. Choice of transport and destination are decided based on a patient’s status, the receiving hospital’s clinical capabilities, transfer time from

Design

We used a qualitative approach aimed to provide an in-depth, holistic and contextual understanding (cf. [24]) of trauma patients’ experiences of HEMS. The participants were purposely selected and data collected by means of individual interviews with open-ended questions (cf. [24]).

Procedure

The inclusion criteria were: over 18 years of age, having suffered a trauma (defined as unintended physical injury) and having received primary transport from the accident scene to a hospital by HEMS. The trauma should

Findings

The analysis resulted in three themes describing the meanings of trauma patients’ experiences of HEMS. When the trauma happened, some participants realized its seriousness and described a fear of dying and struggling to stay alive. Others described that they realized they were injured, but were unsure about how serious it was and felt embarrassed about calling EMS, not knowing if it was necessary. Table 2 shows a schematic overview of the analysis. A description of each theme is presented under

Discussion

The aim of this study was to describe trauma patients’ experiences of HEMS. The findings showed that the participants found it difficult to assess and realize the seriousness of their injuries. The use of HEMS indicated that, in fact, they were serious, and that made participants somewhat frightened about the extent of their injuries. At the same time, the participants were appreciative of HEMS, as healthcare staff took the situation seriously.

The findings also show that, in their encounters

Conclusions

Patients who suffer traumatic injuries are in a vulnerable situation, shocked by their sudden injury and unsure of it severity. HEMS are viewed as serious responses taken by EMS, as the patients experience it as the ‘best way to get to a hospital’. Being taken seriously lays the foundation for patients to be able to trust in caregivers. HEMS provide advantageous circumstances for a positive caring environment, such as often being the sole patient to care for, having close proximity during

Funding

This research received no specific grant from any funding.

Conflict of interests

The authors declare there is no conflict of interest.

Author contributions

Study design: LS, ÅE, CN, PJ. Data collection: LS. Data analysis: LS, ÅE, CN, PJ. Manuscript preparation: LS, ÅE, CN, PJ.

Acknowledgements

We would like to thank the participants for sharing their experiences.

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View full text

The helicopter as a caring context: Experiences of people suffering trauma

Highlights

Abstract

Introduction

Aim

Method

Findings

Conclusion

Introduction

Section snippets

Background

Design

Procedure

Findings

Discussion

Conclusions

Funding

Conflict of interests

Author contributions

Acknowledgements

Int Emerg Nurs

Air Med J

Int Emerg Nurs

Accid Emerg Nurs

Wilderness Environ Med

Resuscitation

Resuscitation

Curr Anaesth Crit Care

Trends Anaesth Crit Care

Br J Anaesth

Int J Nurs Stud

J Emerg Nurs

Accid Emerg Nurs

Air Med J

Injury

Int J Nurs Stud

Chin J Traumatol

Helicopter scene transport of trauma patients with non-life-threatening injuries: a meta-analysis

J Trauma Acute Surg

When is the helicopter faster? A comparison of helicopter and ground ambulance transport times

J Trauma Acute Care Surg