Summary

Helicopter medical assistance, also known as the Helicopter Emergency Mobile Service (HEMS), is one of the main vectors of providing rapid care to patients. Its raison d’être lies in its ability to reduce response times, enabling victims to receive the care their condition requires as quickly as possible. This concept of rapid life-saving action is an essential medical principle and an evolution in emergency medical services and rescue. It allows medical teams to act more quickly and complements land-based medical rescue. The HEMS has become an operational unit combining a medical team, a set of technical and medical equipment for care and resuscitation enabling the care of patients in critical condition using a helicopter equipped and adapted for these missions. However, to be fully efficient and carry out a wide range of missions of varying complexity, it must be part of a coordinated health system. This synthetic review explains the complex organisation of HEMS and the constraints to which they are subject. It gives an indication of the fundamental principles that are essential for doctors and carers who have to use this medium. It covers the safety conditions required for these missions, the consequences of altitude and the rotary wing on patient care, the use of the equipment and the minimum training required, as well as the essential knowledge needed to join an EMS. For practitioners, it covers the indications for these missions, the preparation of the patient before transport to the hospital relay, the management procedures linked to the use of the winch and the physiological constraints linked to flying. Finally, specific situations related to the type of patient and the clinical presentation are discussed, providing a comprehensive overview of the practice of heliborne emergency medicine.