Helicopter and Fixed-Wing Air Medical Transport in a Resource-Limited Region of Eastern Anatolia: Epidemiological Patterns and Operational Challenges in Van Province, Turkey (2022-2025)
Air Medical Journal, 2026 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.amj.2026.06.005
- Dergi Adı: Air Medical Journal
- Derginin Tarandığı İndeksler: Scopus, CINAHL, EMBASE, MEDLINE
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Air ambulance services are essential for patient transport in geographically isolated and resource-limited regions. Van Province, located in the easternmost part of Turkey, features mountainous terrain, harsh winters, and frequent road closures. Despite the critical role of air medical transport in such challenging environments, epidemiological data from these regions remain scarce. This study aimed to characterize the distinct operational roles, patient demographics, and clinical indications for helicopter versus fixed-wing air ambulance transport in a geographically challenging, resource-limited region. Methods: We conducted a retrospective, descriptive epidemiological study analyzing all air ambulance transports (n = 940) coordinated by the Van Provincial Emergency Medical Services between January 1, 2022, and December 31, 2025. Demographic, clinical, and operational data were compared between helicopter and fixed-wing transports. To address the well-known limitation that the Glasgow Coma Scale (GCS) is not interpretable in patients who are pharmacologically sedated or intubated, the primary GCS comparison was performed in a subset of 738 patients after excluding 190 patients who were intubated, mechanically ventilated, or sedated at the time of preflight assessment; the excluded group is described separately. Results: Of 940 patients, 537 (57.1%) were transported by helicopter and 403 (42.9%) by fixed-wing aircraft. Helicopter patients were significantly older (38.4 vs. 18.4 years, P <.001) and predominantly adults (70.9%). Fixed-wing aircraft primarily transported neonates and children (71.0%), particularly those with congenital heart disease (n = 147, 92.5% fixed-wing). After excluding patients who were intubated, mechanically ventilated, or sedated (n = 190), mean preflight GCS was 14.7 ± 1.4 in the helicopter group versus 14.2 ± 1.6 in the fixed-wing group (P <.001); although this difference was statistically significant, the magnitude of this difference is unlikely to be clinically meaningful, as both groups were essentially alert. The geographically isolated Bahçesaray district accounted for 295 patients (31.4%), all of whom were transported by helicopter. All 52 scene responses were performed exclusively by helicopters. Conclusion: Helicopter and fixed-wing aircraft serve distinct and complementary roles in the air medical system of eastern Turkey. These findings provide an operational reference for resource-limited regions and underscore the need for outcome-linked research to evaluate clinical effectiveness.