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直升机紧急救护服务(HEAS)转运:创伤患者病例组合、损伤严重程度及结局分析

Helicopter Emergency Ambulance Service (HEAS) transfer: an analysis of trauma patient case-mix, injury severity and outcome.

作者信息

Melton J T K, Jain S, Kendrick B, Deo S D

机构信息

Department of Trauma and Orthopaedics, The Great Western Hospital, Swindon & Marlborough NHS Trust, Swindon, UK.

出版信息

Ann R Coll Surg Engl. 2007 Jul;89(5):513-6. doi: 10.1308/003588407X202074.

Abstract

INTRODUCTION

A retrospective review of all patients transferred by helicopter ambulance to the Great Western Hospital over a 20-month period between January 2003 and September 2004 was undertaken to establish the case-mix of patients (trauma and non-trauma) transferred and the outcome.

PATIENTS AND METHODS

Details of all Helicopter Emergency Ambulance Service (HEAS) transfers to this unit in the study time period were obtained from the three HEAS providers in the area and case notes were reviewed.

RESULTS

There were 156 trauma patients transferred (total 193) in the study period with 111 cases identified for analysis with a mean age of 33 years (range, 1-92 years). Average Injury Severity Score on admission was 12 (range, 1-36). Forty-five patients were discharged home from the emergency department, 24 cases had operation, 10 patients required ICU care and 2 were pronounced dead in the emergency department. Average hospital stay following HEAS transfer was 2.97 days (range, 0-18 days).

DISCUSSION

Helicopter ambulance transfer in the acute setting is of debated value. Triage criteria are at fault if as many as 41% of patients transferred are being discharged home from casualty having incurred the financial cost of helicopter transfer. We suggest that the triage criteria for helicopter emergency transfer should be reviewed.

摘要

引言

对2003年1月至2004年9月这20个月期间通过直升机救护车转送至大西部医院的所有患者进行了回顾性研究,以确定转送至该院的患者(创伤患者和非创伤患者)的病例组合情况及转归。

患者与方法

从该地区的三家直升机紧急救护服务(HEAS)提供商处获取了研究期间所有转送至本单位的直升机紧急救护服务的详细信息,并对病历进行了审查。

结果

研究期间共转送至该院193例患者,其中创伤患者156例,确定111例进行分析,平均年龄33岁(范围1 - 92岁)。入院时平均损伤严重度评分为12分(范围1 - 36分)。45例患者从急诊科出院回家,24例接受了手术,10例患者需要重症监护病房(ICU)护理,2例在急诊科被宣布死亡。直升机紧急救护服务转送至该院后的平均住院时间为2.97天(范围0 - 18天)。

讨论

在急性情况下,直升机救护车转运的价值存在争议。如果多达41%的转运患者在承担了直升机转运的经济成本后从急诊室出院回家,那么分诊标准就存在问题。我们建议对直升机紧急转运的分诊标准进行审查。

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