Abstract
Introduction: Helicopter Emergency Medical Services (HEMS) exists to supplement the operations of groundbased
emergency care providers, mainly in high acuity cases. One of the important procedures frequently carried
out by HEMS personnel is endotracheal intubation. Several HEMS providers exist in South Africa, with a mix of
advanced life support personnel, however intubation success rates and adverse events have not been described in
any local HEMS operation.
Methods: This was a retrospective chart review of intubation-related data collected by a HEMS operation based
in Johannesburg over a 16-month period. First-pass and overall success rates were described, in addition to
perceived airway difficulty, adverse events and other data.
Results: Of the 49 cases recorded in the study period, one was excluded leaving 48 cases for analysis. Most cases
(n=34, 71%) involved young male trauma patients who were intubated with rapid sequence intubation. The
first pass success rate was 79% (n=38) with an overall success rate of 98% (n=47). At least one factor
suggesting airway difficulty was present in 29% (n=14) of cases, with most perceived airway difficulty related
to the high prevalence of trauma cases. At least one adverse event occurred in 27% (n=13) of cases with
hypoxaemia, hypotension and bradycardia most prevalent.
Discussion: In this small sample of South African HEMS intubation cases, we found overall and first-pass success
rates comparable to those reported in similar contexts.