Submitted in fulfillment of the requirements for the degree of Master of Technology: Emergency Medical Care, Durban University of Technology, Durban, South Africa, 2015. / Introduction: A Helicopter Emergency Medical Service (HEMS) is a specialist flying emergency service where on-board medical personnel have both the knowledge and equipment to perform complicated medical procedures. There is an absence of literature describing the types of patients treated and the clinical outcome of these patients flown by Helicopter Emergency Medical Services within South Africa. The paucity of literature on this topic poses a challenge for current aeromedical services as there is no baseline information on which to base flight criteria, staffing and policy documents. This has the potential to hamper the advancement of HEMS within South Africa. Purpose of the study: The purpose of this study was to undertake a descriptive analysis of the patients flown by the Netcare 911 HEMS over a 12 month period in both Gauteng and KwaZulu-Natal and to assess the patients’ outcomes. The objectives of the study were to analyse the clinical demographics of patients transported by the Netcare 911 HEMS operation, determine the time frames from dispatch of the helicopter to delivery of the patient to the receiving hospital and undertake a correlational analysis of crew qualifications, clinical procedures performed and their outcomes at 24 hours and 72 hours. A further objective was to make recommendations regarding the refinement of current aeromedical policies as well as the education and training requirements. Methodology: The research study was conducted utilizing a retrospective quantitative, descriptive design to undertake an analysis of patients transported by a private helicopter emergency medical service within South Africa. The records of all patients transported by the Netcare 911 HEMS operations between 01 January 2011 and 31 December 2011 were included. Results: In the 12 month study period there were a total of 547 cases. However, the final study population was made up of 537 cases as 10 cases had to be excluded due to incomplete documentation. Of the 537 cases, 82 (15.3%) were managed by the KwaZulu-Natal HEMS and 455 (84.7%) were managed by the Gauteng HEMS. Findings revealed that the majority of patients flown in both Gauteng and KwaZulu-Natal were adult males: males (n=398; 74.1%) and adults (n=437; 81.4%). Motor vehicle accidents were the most common incident type for both operations (n=193; 36%). At the 24-hour follow up, 339 (63.1%) patients were alive and stable and at the 72-hour follow up, 404 (75.3%) were alive and stable. Conclusion and recommendations The findings of this study provide valuable information that may have an impact on the current staffing and authorization criteria of South African HEMS operations.

Dissertation submitted in fulfillment of the requirements for the Degree of Master in Technology: Emergency Medical Care, Durban University of Technology, 2011. / Background Information regarding pre-hospital emergency medical services is limited and it is therefore challenging to determine if there is delay in emergency transport of patients. This study aimed to provide such information specifically regarding the emergency transportation of obstetric patients. Purpose The purpose of the study was to describe the transport of obstetric patients within the Ugu Health District of KwaZulu Natal, in terms of patient profiles, the response time intervals and factors that affected response times. Objectives The objectives of the study were to:  determine response time intervals from the initial call to delivery of the patient to a public sector hospital;  describe the types of obstetric cases being transported;  describe factors that affect response times and;  make recommendations on policies and procedures governing emergency obstetric patient transportation Methodology All obstetric patients transported by Emergency Medical Rescue Service (EMRS) within a 2 month time frame within the Ugu District made up the study population. The study was conducted through prospective quantitative data collection using hospital records, the EMRS information system (communications centre data base records) and the EMRS patient return forms. The data was triangulated which established reliability before descriptive analysis was conducted. vi Findings The EMRS predominantly transports obstetric patients in labour with a gravidity of 1. The mean response interval (from receipt of the call to arrival at the patient) of 1h41minutes was a result of delays in the pre-response interval (pre-response waiting time). The mean pre-response interval of 1h07 minutes was a result of delays caused by ambulance unavailability. Pearson‟s correlation showed a significant relationship between the pre-response interval and response interval i.e. delays in the pre-response interval caused delays in the response interval. The EMRS lacks Standard operating procedures governing emergency transport and this was one of the main factors that contributed to some of the causes of ambulance unavailability. The lack of standard operating procedures is therefore also partly responsible for a delayed response interval. 64.5% of the incidents achieved response time intervals of more than 1hour and has therefore failed to achieve the predetermined Department of Health target for 70% of ambulances reaching the site of the patient within 1 hour. Other factors that affect the response time intervals were the poor road conditions, shift change delays and re-routing of ambulances. Conclusion EMRS predominantly transports obstetric patients in labour, including high risk patient groups that are arguably beyond the scope of care of the Basic and Intermediate qualified Emergency Care Practitioners. Standard operating procedures for governing emergency transport are lacking and have contributed to a number of factors affecting response time intervals. Standard operating procedures therefore need to be developed taking into consideration the findings of this study as well as previous recommendations by the National Committee on Confidential Enquiries into Maternal Deaths (NCCEMD).