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Successful Intervention by Helicopter Emergency Medical Services in a Case of
Severe Head Injury

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S. Hisamoto, T. KIshikami, M. Fukui, K. Yoshida, M. Kunikata, and M. Abe 3
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Nursing Department Emergency Center, Kagawa University Hospital, Japan, Nursing Department
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Cardiovascular Center, Kagawa University Hospital, Japan, and Nursing Department, Kagawa
University Hospital, Japan
Background: In April 2022, Helicopter Emergency Medical Services (HEMS) were introduced in Kagawa
Prefecture, playing a crucial role in providing rapid medical assistance to critical patients.

Objective: To evaluate HEMS effectiveness through the case study of a severe head injury patient
transported via HEMS.

Methods: Data were collected from HEMS and medical records.

Results: A patient in her 30s had a bicycling accident on a remote island, approximately 2 hours from
Oral Presentation Abstracts
our hospital by land and sea routes. She fell 2-3 meters into a roadside ditch and an emergency call
was made. The emergency team requested HEMS, and flight staff reached the patient 17 minutes
later. Upon contact, the patient had a Glasgow Coma Scale (GCS) score of E1V5M6, a dilated right pupil
with no light reflex, a respiratory rate of 24 breaths per minute, and a weak radial pulse. An intravenous
line was immediately secured, and tranexamic acid (an antifibrinolytic) and an antiemetic were
administered due to observed vomiting. Anticipating further deterioration of consciousness, the
patient was intubated and transported to our hospital, where advanced medical care could be
provided. From the time of first contact a total of 31 minutes had elapsed. Post-admission, she was
diagnosed with a cerebral contusion, acute epidural hematoma, and traumatic subarachnoid
hemorrhage. Intensive neurological care was administered, and she was discharged 19 days after
admission, able to walk independently.

Conclusion: The “golden hour” highlights the critical importance of providing prompt medical
treatment within the first hour after a traumatic injury, significantly influencing survival and recovery
outcomes. HEMS greatly enhanced speed and accessibility, allowing for specialized pre-hospital care
and rapid transport to a hospital capable of advanced medical treatment. This timely intervention
demonstrates the effectiveness of HEMS in improving survival rates and outcomes for critically ill or
injured patients.

Keywords: helicopter, air ambulance, trauma, emergency medical service

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Correspondence: Sayaka Hisamoto, Nursing Department Emergency Center,
Kagawa University Hospital, Japan
E-mail: hisamoto.sayaka@kagawa-u.ac.jp

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