The Swiss bus accident on 13 March 2012: lessons for pre-hospital care

limited and expensive resource, and their possible eff ect on outcomes for trauma patients remains a subject of debate [1]. Last March, when a bus carrying 52 people, including 46 children, collided with a tunnel wall, Switzerland was fortunate to have such a well-organized HEMS system. Th e response to the accident proved that this system can provide a number of physician-staff ed helicopters to a scene quickly (in less than 60 minutes) and at night. Th is response was the topic of an article by Lyon and Sanders [2] in a recent issue of Critical Care, which I read with great interest. As a member of one of the fi rst HEMS crews on the scene, I would like to add some signifi cant details. Th e article stated that eight helicopters arrived on the scene and fl ew the most badly injured children directly to university hospitals. Actually, there were initially seven helicopters on the scene: four from Air Zermatt, two from Air-Glaciers, and one from the Rettungsfl ugwacht/ Garde Aérienne (REGA). Th ere was just one direct fl ight of a severely injured girl to a university hospital after she had received pre-hospital anesthesia. Th e majority of fl ights were short transports to a nearby hospital. Only later did a helicopter provide a relocation of one patient to a university hospital. I would like to add some general information about the Swiss HEMS. Th e REGA covers the greater part of Switzerland. However, one area not covered by the REGA is the canton of Valais, in which the accident took place. In this canton, HEMS is provided by two air rescue services (Air Zermatt and Air-Glaciers), which provided the majority of rescue fl ights in this accident. Although the rescue system is regulated independently by each canton, the response to this accident showed how smoothly the diff erent rescue organizations work together when necessary.