Eckstein Marc, Jantos Thomas, Kelly Nicole, Cardillo Anthony
Department of Emergency Medicine, University of Southern California School of Medicine, Los Angeles, California, USA.
J Trauma. 2002 Aug;53(2):340-4. doi: 10.1097/00005373-200208000-00025.
Helicopter transport of pediatric trauma patients in an urban Emergency Medical Services system remains controversial.
A retrospective review of pediatric patients transported by helicopter to a pediatric trauma center in Los Angeles, California, was conducted over a 3-year period. Pediatric patients (age < 15 years) are transported by helicopter if ground transport to a pediatric trauma center would exceed 20 minutes. Emergency Medical Services reports and hospital records were reviewed for key prehospital and outcome indicators.
One hundred eighty-nine patients met the study inclusion criteria. The median age was 5 years (range, 0-14 years). The most common mechanisms of injury were falls and automobile versus pedestrian crashes. Eighty-two percent of patients had a Revised Trauma Score > 7. Of the 175 (93%) patients whose hospital records were available, 24 (14%) were intubated in the emergency department, 32 (18%) were admitted to the intensive care unit, and 7 (4%) were taken directly to the operating room. Injury Severity Scores (ISSs) were as follows: ISS 0 to 15, 146 (83%); ISS 16 to 30, 26 (15%); and ISS > 30, 3 (2%). Fifty-seven (33%) patients were discharged home from the emergency department.
The majority of pediatric trauma patients transported by helicopter in our study sustained minor injuries. A revised policy to better identify pediatric patients who might benefit from helicopter transport appears to be warranted.
在城市紧急医疗服务系统中，直升机转运儿科创伤患者仍存在争议。
对加利福尼亚州洛杉矶一家儿科创伤中心在3年期间通过直升机转运的儿科患者进行回顾性研究。如果地面转运至儿科创伤中心的时间超过20分钟，则使用直升机转运儿科患者（年龄<15岁）。审查紧急医疗服务报告和医院记录以获取关键的院前指标和结果指标。
189名患者符合研究纳入标准。中位年龄为5岁（范围0 - 14岁）。最常见的受伤机制是跌倒以及汽车与行人碰撞。82%的患者修订创伤评分>7。在可获取医院记录的175名（93%）患者中，24名（14%）在急诊科进行了气管插管，32名（18%）被收入重症监护病房，7名（4%）直接被送往手术室。损伤严重程度评分（ISS）如下：ISS 0至15，146名（83%）；ISS 16至30，26名（15%）；ISS>30，3名（2%）。57名（33%）患者从急诊科出院回家。
在我们的研究中，通过直升机转运的大多数儿科创伤患者受轻伤。似乎有必要修订政策，以更好地识别可能从直升机转运中受益的儿科患者。
