A decade of aeromedical care for the older adult: a 10-year review of Irish HEMS cases in patients aged 65 and over.
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · 2025-11-04 · Observational study
Abstract
BACKGROUND: Since its inception in 2012, the Helicopter Emergency Medical Service (HEMS) has become a key component of Ireland's emergency care framework, particularly in supporting access to specialised care centres for major trauma, stroke, and ST-elevation myocardial infarction (STEMI). With an aging population - expected to exceed 1.1 million people aged 65 and older by 2031 - the demand for aeromedical transport of older adults is increasing. Older patients often present complex clinical scenarios due to frailty, polypharmacy, and comorbidities. However, the utilisation and effectiveness of HEMS in this population remain under-examined. This study aimed to provide a 10-year review of HEMS missions involving patients aged ≥ 65 years in Ireland. METHODS: A retrospective cohort study was conducted on Irish HEMS missions between January 2013 and December 2022. Data on patient demographics, mission profiles, clinical interventions, and transport decisions were collected using multiple sources including initial emergency call and dispatch information, patient care reports and end of shift logs. RESULTS: Of 7,857 total HEMS missions over the 10-year period, age data was available for 5,815 patients and 1,875 (32.2%) involved patients aged ≥ 65 years. The median patient age was 74. Primary dispatches accounted for 48.7% of missions, with acute coronary syndromes (60.1%) and trauma from road traffic collisions (26.0%) being the leading medical and traumatic causes, respectively. The standdown rate was 16.8%. Most missions occurred in spring and summer (58%) and were more common in rural counties such as Mayo and Galway. It was shown that 24% of patients were not transported by helicopter, with 5.6% of those transported taken to primary percutaneous intervention centres and 6.2% of patients transported to Dublin based hospitals. CONCLUSIONS: Older adults represent a significant proportion of HEMS activity in Ireland. While HEMS plays an important role in facilitating access to emergency care for this group, particularly in rural areas, patterns in dispatch, transport decisions, and destination hospitals highlight areas for system development. Enhanced age-specific triage protocols and further integration of geriatric considerations into aeromedical planning may improve equity and effectiveness as demand continues to grow.
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Tags
Helicopter & air ambulance · Older adults · Rural & remote
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