Transportation of patients to hospital by ambulance from the mountainous area of Kochi prefecture has been reported to take about twice as long as the national average. Possible reasons are that 85% of the area is mountainous, the transportation network in Kochi is poor, highly advanced medical institutions are concentrated in the central part of the prefecture, and there is a shortage of doctors. To overcome this problem, we have been operating a helicopter emergency medical service (HEMS). The aim of the HEMS is not only rapid transportation of patients to hospital, but also delivery of medical staff who can initiate critical care immediately at the scene.
Here we examined the role and problems of helicopter transportation in regional medicine. We reviewed 314 patients with orthopedics conditions among trauma cases transported by helicopter between March 2005 and August 2011. The main causes of injury were traffic accidents (100 cases, 38.8%), falls from a height (87 cases, 27.7%) and falls due to slipping (39 cases, 12.4%). One hundred thirty-nine cases required emergency surgery. Ninety-five patients were transported from rural hospitals and 37 patients from clinics. Helicopter transportation ensures that initial treatment can be started immediately and patients can be transported safely and quickly to highly advanced medical institutions. We consider that helicopter transportation is useful for minimizing preventable trauma death and disability, and can reduce differences in regional medicine availability. However, helicopter transportation has various problems such as flight difficulty at night or in bad weather, and effective maintenance of the system will be necessary in future.
