Helicopter and ambulance responding to accident

HEMS vs. EMS: Which Emergency Service Gets You the Best Shot at Survival?

Q: Does helicopter emergency medical service (HEMS) really improve survival rates compared to ground emergency medical service (EMS) for trauma patients?

A recent study focusing on trauma patients at Frankfurt University Hospital between 2009 and 2013, revealed that patients transported via HEMS had significantly lower unadjusted mortality rates compared to those transported by EMS. After adjusting for factors like reanimation and age, HEMS was associated with a significant reduction in in-hospital mortality. This suggests that HEMS can offer a notable survival advantage in certain trauma cases.

Q: What specific factors were identified as predictors of mortality in trauma patients, and how do these factors influence treatment decisions?

Several factors were identified as key predictors of mortality in trauma patients. These include a Glasgow Coma Scale (GCS) score of 8 or higher, indicating the level of consciousness; a lower Revised Trauma Score (RRsys), reflecting the patient's physiological condition; an Injury Severity Score (ISS) at Head/Neck >= 3, highlighting the severity of head and neck injuries; and a total ISS >= 9, indicating the overall severity of injuries. These predictors help healthcare providers assess the patient's risk and determine the most appropriate course of action.

Samir D’Costa in Health & Wellness August 2025 • 4 min read.

"A data-driven look at how helicopter emergency medical services (HEMS) stack up against ground EMS in trauma care."

In emergency situations, especially those involving severe trauma, the speed and quality of medical care can significantly impact a patient's chances of survival. For decades, both ground emergency medical services (EMS) and helicopter emergency medical services (HEMS) have been vital components of trauma care systems. However, understanding when and how each service provides the greatest benefit remains a critical question for healthcare providers and policymakers alike.

The use of HEMS has sparked ongoing discussions regarding its cost-effectiveness and clinical advantages compared to traditional ground EMS. While HEMS offers the potential for faster transport and access to specialized care, its higher operational costs necessitate a careful evaluation of its impact on patient outcomes. Is HEMS truly superior in improving survival rates, and if so, under what circumstances does it offer the most significant advantage?

This article delves into a detailed analysis comparing HEMS and EMS in the context of trauma patient care. Drawing upon a comprehensive study of 1,646 trauma patients, we will explore the key factors that influence survival rates and overall outcomes. By examining the data-driven evidence, we aim to provide clarity on the comparative effectiveness of HEMS and EMS, offering insights that can inform decision-making in emergency medical services and ultimately improve patient care.

HEMS vs. EMS: Decoding the Data on Trauma Patient Outcomes

Helicopter and ambulance responding to accident

A recent study meticulously analyzed data from 1,646 trauma patients treated at Frankfurt University Hospital between 2009 and 2013. The goal was to compare the effectiveness of HEMS and EMS in terms of in-hospital mortality and short-term outcomes, measured by the Glasgow Outcome Scale (GOS). The study revealed several key findings:

Unadjusted mortality rates were significantly lower in the HEMS group compared to EMS (p = 0.001). This initial observation suggested a potential survival advantage for patients transported via helicopter.

Reduced Mortality: After adjusting for factors like reanimation and age, HEMS was associated with a significant reduction in in-hospital mortality (p = 0.014, OR = 0.21).
Key Predictors: The study identified several predictors of mortality, including a Glasgow Coma Scale (GCS) score of 8 or higher (p = 0.001), lower Revised Trauma Score (RRsys) (p < 0.001), Injury Severity Score (ISS) at Head/Neck >= 3 (p = 0.003), and total ISS >= 9 (p < 0.001).
Time Matters: Total rescue time and on-scene time were associated with mortality (p<0.001), although these factors were not included in the multiple logistic regression model.
Improved Outcomes: Short-term outcomes (GOS) were significantly improved with HEMS (p=0.014).

These findings suggest that HEMS can offer a survival advantage, particularly for severely injured trauma patients. However, the study also highlights the importance of considering other factors, such as the patient's physiological condition and the timeliness of care.

Making Informed Decisions in Emergency Trauma Care

The decision to utilize HEMS or EMS in trauma care is complex, requiring careful consideration of various factors. While HEMS demonstrates the potential to improve survival rates and outcomes, it is not a one-size-fits-all solution.

Several factors must be considered to determine the most appropriate mode of transport:

Ultimately, the goal is to optimize the delivery of timely and effective care, maximizing the chances of survival and positive outcomes for trauma patients.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.injury.2018.12.018, Alternate LINK

Title: Competitive Advantage Gained From The Use Of Helicopter Emergency Medical Services (Hems) For Trauma Patients: Evaluation Of 1724 Patients

Subject: Orthopedics and Sports Medicine

Journal: Injury

Publisher: Elsevier BV

Authors: M. Weinlich, P. Martus, M.B. Blau, H. Wyen, F. Walcher, S. Piatek, J.P. Schüttrumpf

Published: 2019-05-01

Everything You Need To Know

Does helicopter emergency medical service (HEMS) really improve survival rates compared to ground emergency medical service (EMS) for trauma patients?

A recent study focusing on trauma patients at Frankfurt University Hospital between 2009 and 2013, revealed that patients transported via HEMS had significantly lower unadjusted mortality rates compared to those transported by EMS. After adjusting for factors like reanimation and age, HEMS was associated with a significant reduction in in-hospital mortality. This suggests that HEMS can offer a notable survival advantage in certain trauma cases.

What specific factors were identified as predictors of mortality in trauma patients, and how do these factors influence treatment decisions?

Several factors were identified as key predictors of mortality in trauma patients. These include a Glasgow Coma Scale (GCS) score of 8 or higher, indicating the level of consciousness; a lower Revised Trauma Score (RRsys), reflecting the patient's physiological condition; an Injury Severity Score (ISS) at Head/Neck >= 3, highlighting the severity of head and neck injuries; and a total ISS >= 9, indicating the overall severity of injuries. These predictors help healthcare providers assess the patient's risk and determine the most appropriate course of action.

Does the amount of time spent at the scene or during transport affect a trauma patient's chances of survival when comparing HEMS and EMS?

Yes, the study indicated that total rescue time and on-scene time were associated with mortality, suggesting that timeliness of care is critical in trauma cases. While these factors were not included in the multiple logistic regression model, their impact on survival underscores the importance of minimizing delays in providing medical attention and transport.

Besides mortality rates, are there other ways HEMS impacts trauma patient outcomes, and how are these outcomes measured?

The Glasgow Outcome Scale (GOS) was used to measure short-term outcomes in trauma patients. The study found that short-term outcomes, as measured by GOS, were significantly improved with HEMS compared to EMS. This suggests that HEMS not only contributes to lower mortality rates but also enhances the quality of life and functional recovery for trauma patients.

What are the key considerations when deciding whether to use HEMS versus EMS for trauma care, and how do these services compare in terms of cost-effectiveness?

Deciding between HEMS and EMS involves considering numerous factors. HEMS can potentially improve survival rates and outcomes, particularly for severely injured patients needing rapid transport to specialized care. However, the decision isn't straightforward. Factors like patient condition (GCS, RRsys, ISS), time sensitivity, and the availability of appropriate resources all play a role. The higher operational costs of HEMS necessitate a careful evaluation of its impact on patient outcomes to ensure its cost-effectiveness.