Domeier Robert, Scott Philip, Wagner Christopher
Air Med J. 2004 Jul-Aug;23(4):28-31. doi: 10.1016/j.amj.2004.05.001.
A recent study in the Journal of Neurosurgery demonstrates decreased mortality rates in patients with subarachnoid hemorrhage (SAH) treated at tertiary care centers with higher volumes of SAH patients.(1) As clinical research in emergency and critical care increases, so will its impact on transport systems. In recent years, advances in cardiology, interventional radiology, surgery, and emergency care all have had major influences in the triage and transport of critically ill and injured patients. The challenge facing modern transport systems is how to integrate research to improve patient care while respecting the logistic, financial, and political issues that are entwined in this process. This article discusses the process undertaken by one medical control zone in the triage and transport of prehospital patients with suspected ischemic stroke. It discusses the transition from initial research and national recommendations for emergent thrombolytic therapy through the development and implementation of prehospital triage protocols. The authors hope it will offer some guidance in dealing with these rapidly emerging and often complicated transport decisions.
《神经外科杂志》最近的一项研究表明，在治疗蛛网膜下腔出血（SAH）患者数量较多的三级医疗中心，患者的死亡率有所下降。(1) 随着急诊和重症监护领域临床研究的增加，其对转运系统的影响也会增大。近年来，心脏病学、介入放射学、外科手术和急诊护理等方面的进展都对危重症和受伤患者的分诊与转运产生了重大影响。现代转运系统面临的挑战是如何在尊重这一过程中相互交织的后勤、财务和政治问题的同时，整合研究以改善患者护理。本文讨论了一个医疗控制区在对疑似缺血性中风的院前患者进行分诊和转运时所采取的过程。它讨论了从最初的研究以及国家对紧急溶栓治疗的建议，到院前分诊方案的制定与实施的转变。作者希望它能为处理这些迅速出现且往往复杂的转运决策提供一些指导。
