Helicopter Emergency Medical Services within Resource-Limited Settings of Nepal: Insights from a Tertiary Care Center

Introduction: In times of disaster in rural settings, helicopter rescue is crucial. Since the 1990s, helicopters without any medical support have been used to transport patients from remote areas to tertiary care centers. In 2013, private organizations improved pre-hospital care by adding medical teams and equipment, making Helicopter Emergency Medical Services (HEMS) a critical part of emergency care, particularly in remote areas. Methods: This retrospective observational study analyzes patients who were transferred by helicopter to Grande International Hospital (one of the tertiary centers in Kathmandu, Nepal) between May 10, 2018, and May 9, 2024. Patient’s demographics (age, gender, ethnicity), medical conditions/outcomes, and geographic origins were analyzed. Data was analyzed using SPSS version 25. Results: The 782 helicopter rescues show that 68.8% of the participants were men, with a mean age of 47.21 years. Of them, 90.92% were Nepalese, and the majority of cases (42.23%) were transferred from Province 4 of the country. Pneumonia (211 cases), trauma (107), neurological emergencies (85), cardiovascular emergencies (44), and COVID pneumonia (140) were among the major medical reasons for transfer. The COVID pandemic highlighted the importance of HEMS. 40.4% of cases were self-landed, whereas 59.6% of cases were accompanied by HEMS physicians. Interhospital transfers and a sizable portion of high-altitude operations were part of many rescues. With an average hospital stay of 13.73 days and a 14.3% mortality rate, the majority of patients were admitted to the intensive care unit. Conclusion: HEMS has significantly saved lives over the years at a particular tertiary hospital. This data allows for advancing HEMS use in a rural setting like Nepal, especially during times of disaster, to provide acute medical and rescue care. It is imperative to address and evaluate HEMS accessibility and its importance regarding infrastructure, cost, geographic diversity, and the country’s vulnerability to disaster.