Helicopter Emergency Medical Service transports in Finland in 2024: a national prospective observational study

Background Helicopter Emergency Medical Service (HEMS) has been a key component of Finnish Emergency Medical Service since 2012. In recent years, the role of HEMS has evolved due to organizational changes and expanding indications for helicopter transport. In addition, the national HEMS network was extended with the establishment of the first rural physician-staffed HEMS unit, FinnHEMS40 (FH40), in 2022. The aims of this study were to characterize patient groups and clinical features of patients transported by helicopter to university hospitals in Finland, assess the potential time–saving of helicopter transport compared with estimated ground ambulance transport, and describe operational characteristics of FH40 within the national HEMS system. Methods This prospective, observational study was conducted in Finland in 2024. All patients transported by helicopter to university hospitals were included. Primary outcomes were patient characteristics and operational metrics; 30-day survival and neurological outcome were assessed descriptively when available. HEMS physicians recorded patient and mission data using a secure electronic data capture system. Helicopter transport times were recorded, whereas ambulance transport times were estimated. Group comparisons were performed using the Kruskal-Wallis test for continuous variables and Fisher´s exact test for categorical variables. Results In total, 467 of 513 patients (90%) transported by helicopters in 2024 were reported. Most patients were male (293, 63%) and the median age was 64 years (interquartile range (IQR) 44–73). The most common indications for helicopter transport were stroke (200, 43%) and trauma (134, 29%). Helicopter transport times were generally shorter than modelled ambulance transport times. Data for 219 (47%) patients were available at the 30-day follow-up, of whom 183 (84%) were alive. Among survivors, 132 (72%) had a good neurological outcome (Cerebral Performance Category 1–2). Conclusions In 2024, stroke and trauma were the main indications for helicopter transport. Helicopter missions were generally faster than modelled ambulance transports. FH40 accounted for a substantial proportion of long-distance transports to tertiary care. Among patients with follow-up data, survival and neurological outcomes were favorable. Overall, the findings provide an updated national overview of helicopter transports and suggest that helicopter use may facilitate timely access to advanced care, warranting further study of patient-centered outcomes.