![]() Oulu University Hospital is a tertiary level teaching hospital that currently provides treatment for people in Northern Finland in general. ![]() The nearest university hospital is located in the city of Oulu, 166 km (air distance) south from the Lapland Central Hospital. Computed tomography and acute ischaemic stroke thrombolysis are available 24/7. During night time and weekends the availability of PCI is limited. In Central Hospital percutaneous coronary intervention (PCI) is immediately available during office hours. The longest air distance to the hospital from the northernmost borderline is 411 km. The main hospital in the region is Lapland Central Hospital in the city of Rovaniemi. Physician-staffed HEMS unit (FH50) is located within the Oulu University Hospital and offers consultation services 24/7. The paramedics of FH51 are equipped to give more treatments than the personnel of advanced-level ambulances. The Emergency Medical Services (EMS) in the area is a three-level system with first response units, basic-level and advanced-level ambulances. Other airfields have limited availability for those services, which currently reduces the possibilities for IFR missions. FH51 is based at Rovaniemi airport where air-traffic control services are available 24/7. There are 5 airfields in the area that are equipped for instrument flight rules (IFR) operations. The region is remote and sparsely habited, covering only 3% of the Finnish population. The Finnish Lapland accounts for almost 30% of the country’s area. This study was performed in Northern Finland (Finnish Lapland) where the northernmost HEMS unit FinnHEMS 51 (FH51) operates. The HEMS units in Finland are dispatched via Finnish Emergency Response Centre (112 Finland). A rapid response car (RRC) is available in every base for short-range missions and for poor weather conditions. Both helicopter types are certificated for non-icing meteorological conditions only. Three southern bases use Airbus H135 and three northern bases use Airbus H145 helicopters. Five HEMS units are physician-staffed and the northernmost unit is manned with advanced-level paramedics. and there are six HEMS units available 24/7. The Finnish HEMS system is managed by a national administrative company FinnHEMS Ltd. These factors increase the danger of inflight icing if entering visible moisture conditions at low temperatures. However, modern helicopters are widely used in HEMS operations that require flying in instrument meteorological conditions (IMC) and in marginal visual meteorological conditions (VMC). Many helicopter manufacturers have denied their helicopters to be operated in known icing conditions and have instructed pilots to avoid icing environment due to significant safety risks and negative effects on helicopter performance. Nevertheless, the role of icing weather conditions is unknown within denied or cancelled HEMS missions. A significant percentage of denied or cancelled HEMS missions is caused by poor weather conditions. It has been shown that air medical transport improves survival of many patients with medical and trauma emergencies, yet overall more than one third of all helicopter emergency medical service (HEMS) missions are denied or cancelled. ![]()
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