Authors (including presenting author) :
Chan YWW (1)(2), Wong KSJ(2), Lam CYJ(3)(2), Leung CP (4)(2), Leung CY (5)(2), Lam KCH (6)(2), Cheung CKA (7), Chau CW(8)(2), Kwok WHW (9)(2)
Affiliation :
(1) Accident and Emergency Department, New Territories West Cluster, (2) Medical Unit, Government Flying Service (Auxiliary), (3) Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, (4) Nursing Services Division, Ruttonjee & Tang Shiu Kin Hospitals, (5) Accident and Emergency Department, Tuen Mun Hospital, (6) Head Office Clinical Services, Hospital Authority, (7) Outpatient and Emergency Department, Gleneagles Hospital, (8) Accident and Emergency Department, Queen Elizabeth Hospital, (9) Accident and Emergency Department, Yan Chai Hospital
Keyword 1: :
Emergency Nurses on the Frontlines
Keyword 2: :
nursing protocol in prehospital setting
Keyword 3: :
Air Medical Nursing Officer Initiated Treatment Protocol
Keyword 4: :
helicopter emergency medical services
Keyword 5: :
flight nurses in Hong Kong
Introduction :
The Government Flying Service (GFS) is the sole provider of aeromedical evacuation and air ambulance services across Hong Kong and the South China Sea. In response to increasing demand for timely, protocol-driven prehospital care in remote and high-risk environments, the Air Medical Nursing Officer (AMNO) Initiated Treatment Protocol was developed in 2018. This initiative aimed to empower flight nurses with clinical autonomy in decision-making and intervention prior to physician contact, addressing the unique operational challenges of helicopter emergency medical services.
Objectives :
To evaluate the implementation of the AMNO protocol from 2020 to 2024, assess trends in compliance, and analyze its application across disease categories and standardized nursing protocols.
Methodology :
A retrospective review of the patient record system from 2020 to 2024 was conducted. Each case was categorized by clinical presentation and mapped to the corresponding AMNO protocol. Descriptive statistics were used to analyze usage patterns and compliance trends.
Result & Outcome :
A total of 272 cases were identified. The overall compliance rate was 91.2%, with a trend from 76.1% in 2020 to 100% in 2024, reflecting improved training, greater familiarity with protocols, and better operational integration. Case distribution and associated protocols: •Limb Injury (24.5%) → Protocol 8: Severe Pain •Heat Illness (17.2%) → Protocol 2: Hypovolemia / Dehydration •Cardiovascular (CVS) (16.2%) → Protocol 4: Acute Coronary Syndromes •Cardiac Arrest (11.3%) → Protocol 9: Cardiac Arrest •Major Trauma (8.6%) → Protocols 2 & 8 •Respiratory Distress (8.3%) → Protocols 1 & 3 •Gastrointestinal (2.3%) → Protocol 2 •Near Drowning (1.0%) → Protocol 1 •Anaphylaxis (0.3%) → Protocol 7 •Others (10.3%) → Various protocols The protocol enabled timely, nurse-led interventions including oxygen therapy, analgesia, IV fluid resuscitation, and emergency medication use, enhancing prehospital care outcomes. Conclusion: The AMNO protocol has significantly advanced the role of emergency nurses in Hong Kong’s aeromedical system. Its rising compliance and broad applicability demonstrate the value of safe, autonomous nursing practice in prehospital care.
