Helicopter emergency medical service in Italy: reality and perspectives.

Objective: The organization of a homogeneous medical emergency system was developed in Italy in 1999. Currently, 104 stations manage medical emergencies with ambulances and 47 helicopter-capable bases for more difficult missions. The current study describes the organization of the helicopter emergency system in Italy.

Methods: Data were collected from questionnaires filled in by each base commander.

Results: Six hundred twenty-seven physicians are enrolled in helicopter-capable base emergency teams. Of those physicians, 89.5% are specialists in anesthesiology. Professional nurses are enrolled in 46 bases. Twenty-six bases specialize in search-and-rescue (SAR) missions (which take place in geographically unfriendly terrain), where a mountain rescue technician (CNSAS) is part of the team. Twenty-one bases are for missions in geographically friendly terrain (HEMS bases). Eight bases provide 24-hour service. Specialized training is given to physicians and nurses: it is considered of first level (high standard) in 21 bases, of second level (intermediary) in 17 bases, and of third level (low) in nine bases. In the mountain bases (Alps and Apennines), the more widely used helicopters are the AB412 and the BK117C1. During 2004, there were 20,660 primary interventions and 7,790 secondary interventions. From 1999 to 2004 there was a 33% increase of activity for primary and 35% for secondary interventions.

Conclusions: The data show the activity of the helicopter-ambulance service, the role of anesthetists within the helicopter-based Advanced Cardiac Life Support (ACLS) team, and the diverse organization of training for medical staff in different regions of Italy.