Current status of patients with gastrointestinal bleeding transported by physician-staffed helicopter in Japan

Background: Currently, there is very limited analysis of cases where acute gastrointestinal (AGI) bleeding patients have been transported by helicopter. This descriptive study aims to share the Japanese experience with other air ambulance providers. Methods: We retrospectively analyzed data from the Japan doctor helicopter (DH) registry system (JDRS), which was prospectively collected in Japan from April 2015 to March 2020. Inclusion criteria were all cases registered in the JDRS with a diagnosis of gastrointestinal bleeding. Exclusion criteria were cases with unknown outcomes after one month. The following details of the dispatch activity of the subjects were collected: age, sex, vital signs at emergency medical technicians (EMTs)’ contact, DH staff’s contact, and at the receiving hospital, cardiac arrest at EMTs’ contact, DH staff’s contact, and at the receiving hospital, dispatch type, contents of the medical intervention, and the final outcome. Results: During the investigation period, 235 cases were treated as subjects. Males were dominant. The heart rate and shock index at the EMTs’ contact were significantly higher than those at the DH staff’s contact. The respiratory rate and shock index at the DH staff’s contact were significantly higher than those at the hospital. There were 11 cardiac arrests at the DH staff’s contact and 5 (45.5%) of them obtained spontaneous circulation at the hospital. The fatality ratio within one month was 10.6%. Conclusions: This report describes the current status analysis of AGI bleeding cases transported by the DH. Following air evacuation, unstable vital signs improved, and approximately half of the patients achieved return of spontaneous circulation from cardiac arrest.