Abstract:

Objective To define the concept of risk incidents during helicopter emergency medical services （HEMS） transfer，and to provide a reference for early risk prevention and control. Methods A systematic search was conducted on PubMed，Web of Science Core Collection，ProQuest，Embase，CINAHL，China National Knowledge Infrastructure，and Wanfang Database，with a timeframe from January 1，2006 to November 30，2025. Rodgers evolutionary conceptual analysis was applied to analyze the included literature. Results Risk incidents during HEMS included three conceptual attributes，including real-time interaction between aviation and healthcare environment，interprofessional team emergency response collaboration，and immediate damage transmission. The antecedent factors involved patient factors，crew factors，equipment factors，environment factors，and management factors. The posterior outcomes were that，in the event of a risk incident not being promptly controlled，they may jeopardize the patient’s life and prognosis，exacerbate the physical and mental strain on medical personnel，and even compromise the sustainability of the helicopter medical rescue system. Conclusion Helicopter medical transportation is susceptible to various uncertainties，including aviation noise，acceleration，and spatial constraints，which may lead to risk incidents such as patient deterioration，crew safety impairment，and deviation from medical objectives. Future research may integrate artificial intelligence to develop predictive models for risk incidents during HEMS transport，quantifying key risk factors and their threshold indicators. This would enable the formulation of targeted prevention and control strategies，thereby enhancing transport quality and patient safety.

Key words: Helicopter Emergency Medical Services, Transport, Risk Incidents, Rodgers Evolutionary Conceptual Analysis