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Helicopter Emergency Medical Service in Kagawa

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M. Kunikata, M. Abe, S. Hisamoto, K. Yoshida, T. Kishikami, and M. Fukui 3
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1 Nursing Department Emergency Center, Kagawa University Hospital, Japan, Nursing Department,
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Kagawa University Hospital, Japan, and Nursing Department Cardiovascular Center, Kagawa
University Hospital, Japan

Background: In 2022, the implementation of air ambulances in Kagawa enabled all prefectures in
Japan to offer Helicopter Emergency Medical Services (HEMS). HEMS initiate treatment by flight doctors
and flight nurses in an air ambulance before arrival at hospitals. In Kagawa, which has many remote
islands, HEMS is an indispensable means of transportation to continue advanced treatment.

Objective: To describe the performance of HEMS in Kagawa and flight nurses’ activity.

Methods: This retrospective study identified patients treated by Kagawa HEMS from April 2022 to
March 2024. Clinical data were extracted from the Kagawa Air Ambulance database. Descriptive
analyses were performed.

Results: Of 758 dispatches in the 24-month period the most common cases were trauma, followed by
stroke and cardiovascular diseases. The average hospital stay for traffic trauma patients transported
by HEMS was 21.3 days, which was 17.7 days less than the average of 39.0 days for patients transported
by ambulance. In Japan, when an emergency call is received at the Fire-fighting Central Command Oral Presentation Abstracts
Room, an ambulance is dispatched to the scene, while the request for air ambulance dispatch is sent
to a base hospital. HEMS is offered only during the daytime. Upon receiving a request, the helicopter
takes off within 5 minutes and the doctor and nurse prepare necessary items and medications while
receiving patient information via radio during flight. They see patients brought by ambulance at the
rendezvous point and initiate treatment. The on-site stay time is generally 20-30 minutes, during
which time procedures such as securing intravenous access and intubation are performed, and the
patient’s destination is determined. Flight nurses hold monthly case review conferences to enhance
their practical skills in responding to various situations.

Conclusion: HEMS significantly contributes to the survival of patients. Ensuring and further improving
the competency of flight nurses is a future challenge.

Keywords: Emergency Medical Service, helicopter, air ambulance

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Correspondence: Misa Kunikata, Nursing Department Emergency Center, Kagawa University Hospital,
Japan
E-mail: kunikata.misa@kagawa-u.ac.jp

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