Crippen D
Department of Critical Care, St Francis Medical Center, Pittsburgh, PA 15201.
Am J Emerg Med. 1990 Nov;8(6):551-4. doi: 10.1016/0735-6757(90)90163-t.
Regionalization of health care for trauma has become commonplace, and the same concept for critically ill medical/surgical patients is developing. Recent evidence suggests that current stabilization measures used by transport teams can be inadequate for this critically ill patient population. In trauma, speed has been considered a necessity to get the patient to a facility which cannot be carried out to the field, eg, an operating room. For acute medical illnesses, critical care transport teams can bring intensive care technology to the patient. Accumulating evidence supports the premise that speed of transport is not as important as stabilization before transport, knowledge of hemodynamics during transport, and early use of critical care monitoring systems. Other reports identify the need for initial evaluation and stabilization of critically ill patients by physicians at the critical care level of expertise. Accordingly, critical care transportation teams have evolved, creating new notions of pretransport stabilization not applicable to previous transport systems.
创伤医疗保健的区域化已变得很普遍，针对危重症内科/外科患者的相同概念也在发展。最近的证据表明，运输团队目前使用的稳定措施对于这类危重症患者群体可能并不足够。在创伤治疗中，速度被认为是将患者送到无法在现场实施治疗的机构（如手术室）的必要条件。对于急性内科疾病，重症护理运输团队可以将重症监护技术带给患者。越来越多的证据支持这样一个前提，即运输速度不如运输前的稳定、运输过程中的血流动力学知识以及早期使用重症监护监测系统重要。其他报告指出，需要由具有重症监护专业水平的医生对危重症患者进行初始评估和稳定。因此，重症护理运输团队不断发展，产生了以前运输系统所不适用的运输前稳定的新观念。
