Pre hospital care and clinical practice in civilian life is not a new idea, in fact it is has been around in one form or another for roughly 200 years. Its foundations lie in the military. During the Napoleonic wars with a French surgeon named Dominique-Jean Larrey. (1) Pre hospital care has come a long way from hauling fallen soldiers off the battlefield in a horse drawn carriage (1) to transporting patients in a different kind of carriage, a four wheel drive one to be precise. Pre hospital care and clinical practice owes many of its advancements in the 200 years since it has existed to the military. Their practices or research conducted during military conflicts has influenced civilian pre hospital care and clinical practice in the areas of triage systems, transport systems, clinical management, equipment and education to name but a few, but where it has had the most influence has been on the transport systems and clinical practices used. Their uses in the military pre hospital care world have worked particularly well in the civilian world. As a result of such they have been adapted by civilian paramedics quite readily.
Helicopters were first used as an ambulance in the sky during the Korean War (1950-53) (2). But it wasn’t until the late 70’s and early 80’s that helicopters were used in civilian pre hospital care (3). They were introduced to transport people living in remote communities deep in the outback to hospital, to receive the care that they needed but lacked in their rural community. Helicopters are also perhaps more importantly used for transporting patients who have suffered severe trauma or are seriously ill to hospital as they provide a quicker method of transport than the conventional road ambulance. This speed in getting patients to the hospital increases their chance of survival. This belief is attributed to the Golden hour theory. The golden hour theory suggests patients have a golden hour to survive. If they reach hospital after the golden hour then their chances of survival have seriously diminished but if they reach a hospital in time, then chances are they will survive.
“The golden hour is the first 60 minutes after the occurrence of a major multi-system trauma. It is widely believed that the victim's chances of survival are greatest if he or she receives specialized trauma care within the first hour.” (4)
The definition of the golden hour seems so rigid but rather it is flexible in the sense that it could take 1-3 hours to reach the appropriate medical care needed but it does not mean the patient has no hope of survival if they arrive outside of that hour. It merely suggests that time is of the essence when treating patients. This is why the golden hour is the key concept in why helicopters are being used as air ambulances. Before the helicopter was introduce the mortality rate of patients with a serious trauma was higher due to it taking more time for a seriously injured patient to reach a hospital because of a lack...