Gerhardt R T, Stewart T, De Lorenzo R A, Gourley E J, Schreiber M A, McGhee J S
Department of Emergency Medicine, Brooke Army Medical Center/San Antonio Uniformed Services Health Education Consortium, Texas 78234, USA.
Prehosp Emerg Care. 2000 Apr-Jun;4(2):136-43. doi: 10.1080/10903120090941407.
To analyze a high-volume military air ambulance unit and review the U.S. Army air medical transport system and Military Assistance to Safety and Traffic (MAST) program.
The setting was a remote medical system with numerous ground emergency medical services. All patients transported between January 1, 1996, and February 28, 1998, were included. Patients who were dead on scene or for whom records were unavailable were excluded. A retrospective review of transport and available inpatient records was conducted.
Five hundred seventeen patients were transported during the study period; 461 patients met inclusion criteria (89%). Of these, 70% were classified as trauma; 30% possessed medical or other surgical diagnoses. Prehospital responses numbered 71.6%, while 28.4% were interhospital transfers. Missions averaged 23.4 minutes per flight, with no major aircraft mishaps. Prehospital utilization review showed appropriate use; 35% of interhospital trauma and 11% of interhospital nontrauma missions were staffed inadequately by these criteria. Time intervals, procedures, and program impact are discussed.
This and similar units participating in the MAST program provide effective air transport in settings underserved by civilian programs. Quality and wartime readiness could be improved by centralized medical direction, treatment and transfer protocols, and enhanced training of medics. Further investigations of the clinical impact of advanced training and a two-medic aircrew model are warranted.
分析一个大规模的军事空中救护单位,并回顾美国陆军空中医疗运输系统及军事安全与交通援助(MAST)计划。
研究背景为一个拥有众多地面紧急医疗服务的远程医疗系统。纳入1996年1月1日至1998年2月28日期间转运的所有患者。排除现场死亡或记录缺失的患者。对转运记录和可获取的住院记录进行回顾性分析。
研究期间共转运517例患者;461例患者符合纳入标准(89%)。其中,70%被归类为创伤患者;30%患有内科或其他外科疾病。院前响应占71.6%,院际转运占28.4%。每次飞行任务平均时长23.4分钟,未发生重大飞机事故。院前利用情况审查显示使用合理;按照这些标准,35%的院际创伤任务和11%的院际非创伤任务人员配备不足。讨论了时间间隔、操作流程和项目影响。
该单位及参与MAST计划的类似单位在民用项目服务不足的地区提供了有效的空中运输。通过集中医疗指导、治疗和转运方案以及加强医护人员培训,可以提高质量和战时准备状态。有必要进一步研究高级培训和两名医护人员机组模式的临床影响。