{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:02Z","timestamp":1786115762774,"version":"build-2736575974"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Zhoushan Archipelago faces challenges in delivering timely emergency care due to its dispersed geography and centralized medical resources. To address delays associated with ferry transport for critically ill patients on remote islands, a maritime helicopter emergency medical service (HEMS) was established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a pilot, retrospective study of all patients transported by this novel HEMS between March 2024 and June 2025. Data from electronic medical records were analyzed to assess initial feasibility, describe patient demographics, in-flight interventions, and clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In this initial case series of 18 patients, the majority were male (\n                      <jats:italic>n<\/jats:italic>\n                      = 17) with conditions split evenly between traumatic injuries (\n                      <jats:italic>n<\/jats:italic>\n                      = 9) and acute medical events (\n                      <jats:italic>n<\/jats:italic>\n                      = 9). HEMS demonstrated the capability for rapid transfer and advanced in-flight care. Preliminary outcomes indicated that 17 of 18 patients survived to discharge, with several receiving critical surgery within 1 h of arrival. One death occurred in a patient with a severe stroke.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This pilot study suggests that maritime HEMS is a feasible and promising intervention for improving emergency response in remote island settings, with the potential to significantly reduce transfer times. Our initial experience supports the need for larger-scale studies to conclusively determine its impact on patient outcomes. Further improvements in operational efficiency are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1834164","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:16Z","timestamp":1785994336000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A pilot study of helicopter emergency medical services in the Zhoushan Archipelago: clinical experience and operational insights from 18 cases"],"prefix":"10.3389","volume":"14","author":[{"given":"Yongjun","family":"Zheng","sequence":"first","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyun","family":"Lin","sequence":"additional","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junyan","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyang","family":"Chen","sequence":"additional","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhoubo","family":"Wang","sequence":"additional","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuechuan","family":"Shen","sequence":"additional","affiliation":[{"name":"Emergency Department, Zhoushan Hospital of Zhejiang Province, Zhoushan","place":["Zhejiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1001\/jamasurg.2017.4485","article-title":"Comparing the air medical prehospital triage score with current practice for triage of injured patients to helicopter emergency medical services: a cost-effectiveness analysis","author":"Brown","year":"2017","journal-title":"JAMA Surg."},{"key":"B2","first-page":"249","article-title":"Experience and exploration of medical rescue and treatment training of maritime aviation rescue detachment","volume":"30","author":"Liu","year":"2023","journal-title":"Chin J Naut Med Hyperbar Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e840","DOI":"10.1097\/SLA.0000000000005812","article-title":"Direct trauma center access by helicopter emergency medical services is associated with improved survival after severe injury","volume":"278","author":"Deeb","year":"2023","journal-title":"Ann Surg."},{"key":"B4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3760\/cma.j.cn121430-20240111-00034","article-title":"Rescue and protection branch of china medical rescue association expert consensus group on aviation rescue M","volume":"36","year":"2024","journal-title":"Zhonghua Wei Zhong Bing Ji Jiu Yi Xue."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e70436","DOI":"10.1002\/mco2.70436","article-title":"Intracerebral hemorrhage: advances, knowledge gaps, and future directions","volume":"6","author":"Liu","year":"2020","journal-title":"MedComm."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2912","DOI":"10.1097\/CM9.0000000000002885","article-title":"Definition, prediction, prevention and management of patients with severe ischemic stroke and large infarction","volume":"136","author":"Hua","year":"2023","journal-title":"Chin Med J."},{"key":"B7","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s13049-023-01143-4","article-title":"Fatigue risk assessment of a helicopter emergency medical service crew working a 24\/7 shift pattern: results of a prospective service evaluation","volume":"31","author":"Rose","year":"2023","journal-title":"Scand J Trauma Resusc Emerg Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.resuscitation.2018.12.019","article-title":"Lyon RM. 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A retrospective cohort study","volume":"163","author":"Saviluoto","year":"2021","journal-title":"Resuscitation."},{"key":"B10","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s12873-023-00786-x","article-title":"Stress of emergency physicians during helicopter operations: impact of patients' diagnoses, severity of diagnoses, and physicians' work experience","volume":"23","author":"Petrowski","year":"2023","journal-title":"BMC Emerg Meed."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1834164\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:18Z","timestamp":1785994338000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1834164\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":10,"alternative-id":["10.3389\/fpubh.2026.1834164"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1834164","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"1834164"}}