Van Hoving D J, Smith W P, Wallis L A
Division of Emergency Medicine, Stellenbosch University/University of Cape Town, South Africa.
Emerg Med J. 2008 Mar;25(3):136-9. doi: 10.1136/emj.2007.051540.
The South African setting lends itself to the extensive use of air transport. There is a perception with healthcare providers that flight crews spend too much time with a patient before departure. The main advantage of aero medical transport is to minimise the delay to definitive care and prolonged on-scene time defies this objective. A study was carried out to examine the mean on-scene times of aero medical and road transport of critically ill patients in the Western Cape of South Africa.
In this retrospective observational study, all critically ill patients transported in the Western Cape between September 2005 and May 2006 were evaluated. The mean on-scene time for each transport mode was calculated. Road transport was compared with air transport (rotor and fixed wing). Every transport mode was further divided into mission types: "scene" missions (scene to a healthcare facility) or "inter-facility" missions (from one healthcare facility to another).
A total of 7924 transports were included in the study, 7580 of which (95.7%) were road transports. The air transport group spent 53.2 min (95% CI 51.1 to 55.4) at the scene compared with 27.9 min (95% CI 27.5 to 28.4) for the road transport group. There was a significant difference between scene and inter-facility missions in the air transport group (mean 31.7 min for scene missions vs 58.7 min for inter-facility missions; p<0.001). A significant difference was also found in the road transport (mean 24.6 min for scene missions vs 31.9 min for inter-facility missions; p<0.001).
The on-scene time for transport missions by road is significantly less than for those done by air. There are significant differences between scene and inter-facility missions in both transport modes. Capacity building programmes with ongoing education and training of staff at referring facilities should be implemented.
南非的环境适合广泛使用航空运输。医疗服务提供者认为飞行机组人员在出发前与患者相处的时间过长。航空医疗运输的主要优势是尽量减少确定性治疗的延迟，而长时间的现场停留时间违背了这一目标。开展了一项研究，以调查南非西开普省危重症患者航空医疗运输和公路运输的平均现场停留时间。
在这项回顾性观察研究中，对2005年9月至2006年5月期间在西开普省转运的所有危重症患者进行了评估。计算了每种运输方式的平均现场停留时间。将公路运输与航空运输（旋翼机和固定翼飞机）进行比较。每种运输方式进一步分为任务类型：“现场”任务（从现场到医疗机构）或“机构间”任务（从一个医疗机构到另一个医疗机构）。
该研究共纳入7924次运输，其中7580次（95.7%）为公路运输。航空运输组在现场停留53.2分钟（95%可信区间51.1至55.4），而公路运输组为27.9分钟（95%可信区间27.5至28.4）。航空运输组的现场任务和机构间任务之间存在显著差异（现场任务平均31.7分钟，机构间任务平均58.7分钟；p<0.001）。公路运输中也发现了显著差异（现场任务平均24.6分钟，机构间任务平均31.9分钟；p<0.001）。
公路运输任务的现场停留时间明显少于航空运输。两种运输方式的现场任务和机构间任务之间存在显著差异。应实施能力建设计划，并对转诊机构的工作人员进行持续教育和培训。
