A pilot study of helicopter emergency medical services in the Zhoushan Archipelago: clinical experience and operational insights from 18 cases.

BACKGROUND: 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. METHODS: 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. RESULTS: In this initial case series of 18 patients, the majority were male (n = 17) with conditions split evenly between traumatic injuries (n = 9) and acute medical events (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. CONCLUSION: 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.