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配备医生的直升机紧急医疗服务对钝性创伤患者生存率及院前护理的影响。

Effect of physician-staffed helicopter emergency medical service on blunt trauma patient survival and prehospital care.

作者信息

Iirola Timo T, Laaksonen Mikko I, Vahlberg Tero J, Pälve Heikki K

机构信息

Department of Anaesthesia and Intensive Care, Turku University Hospital, University of Turku, Turku, Finland.

出版信息

Eur J Emerg Med. 2006 Dec;13(6):335-9. doi: 10.1097/01.mej.0000224429.51623.fb.

Abstract

OBJECTIVE

The aim of the study was to assess the immediate and long-term effect of a helicopter emergency physician giving advanced life support on-scene compared with conventional load and go principle in urban and rural settings in treating blunt trauma patients.

METHODS

In a retrospective study, 81 blunt trauma patients treated prehospitally by a physician-staffed helicopter emergency medical service were compared with 77 patients treated before the era of the helicopter emergency medical service. The data were collected in the prehospital and hospital files and a questionnaire was sent to the survivors 3 years after the trauma.

RESULTS

The physicians treated the patients more aggressively (gave drugs, intubated and cannulated) and had the patients transported directly to a university hospital. The given treatment did not delay arrival at the hospital. No statistically significant difference was found, but a trend (P = 0.065) to lower survival in the helicopter emergency medical service group. Almost half of the deaths in the helicopter emergency medical service group and none in the control group, however, occurred in the emergency department. No difference was found 3 years later between the groups in the health-related quality of life or decrease in the income owing to the accident.

CONCLUSION

The physicians treated the patients more aggressively, but it did not delay the arrival at the hospital. A beneficial effect of this aggressive treatment or direct transport to a university hospital could not be seen in the immediate physiological parameters or later health-related quality of life. The physician-staffed helicopter emergency medical service was not beneficial to blunt trauma patients in this setting.

摘要

目的

本研究旨在评估在城市和农村环境中,与传统的“装载即转运”原则相比,直升机急救医生在现场进行高级生命支持对钝性创伤患者的即时和长期影响。

方法

在一项回顾性研究中,将81例由配备医生的直升机紧急医疗服务进行院前治疗的钝性创伤患者与77例在直升机紧急医疗服务时代之前接受治疗的患者进行比较。数据收集自院前和医院档案,并在创伤发生3年后向幸存者发送了一份问卷。

结果

医生对患者的治疗更为积极(给药、插管和穿刺),并将患者直接转运至大学医院。所给予的治疗并未延迟到达医院的时间。未发现统计学上的显著差异,但直升机紧急医疗服务组的生存率有降低的趋势(P = 0.065)。然而,直升机紧急医疗服务组几乎一半的死亡发生在急诊科,而对照组无一例死亡。3年后,两组在与健康相关的生活质量或因事故导致的收入减少方面没有差异。

结论

医生对患者的治疗更为积极,但并未延迟到达医院的时间。在即时生理参数或后期与健康相关的生活质量方面,未发现这种积极治疗或直接转运至大学医院有有益效果。在这种情况下,配备医生的直升机紧急医疗服务对钝性创伤患者并无益处。

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