CareFlight, Sydney, New South Wales, Australia.
Eur J Emerg Med. 2014 Apr;21(2):130-5. doi: 10.1097/MEJ.0b013e328362dffa.
The aim of this study was to describe the mechanism and severity of injuries in the paediatric population treated by an Australian helicopter emergency medical service and to examine the frequency and nature of interventions performed. This information is important for planning education and continuing professional development in prehospital medicine.
The study is a retrospective cohort analysis of 349 patients under the age of 16 treated by CareFlight in Sydney, Australia, between April 2007 and April 2012. Data collected included age, type of incident, medication and fluid administered, procedures performed, receiving hospital, 24 h and 30-day mortality and injuries sustained.
Falls (33%), motor vehicle incidents (30%), sport injury (14%) and immersion injury (12%) were the most common mechanisms. A total of 27 children died within 30 days; nontrauma cases were proportionally overrepresented in the deaths. With respect to tasking, 59% cases involved a severely or significantly injured child. Among the children, 97% with a traumatic mechanism were transferred directly to a paediatric trauma centre.In addition, 81% of children had at least one intervention by the helicopter emergency medical services team at the incident scene, most commonly intravenous cannulation (61%), crystalloid bolus (29%), intubation (21%) and intravenous analgesia administration (15%).
Paediatric prehospital patients can be of high dependency, requiring urgent critical care procedures. Training in prehospital medicine should include paediatrics. It is essential that practitioners maintain skills in venous access, airway management and provision of adequate analgesia in children.
本研究旨在描述澳大利亚直升机紧急医疗服务（HEMS）救治的儿科患者的损伤机制和严重程度，并探讨其干预措施的频率和性质。这些信息对于规划院前医学教育和继续教育非常重要。
该研究是对 2007 年 4 月至 2012 年 4 月期间 CareFlight 在澳大利亚悉尼治疗的 349 名 16 岁以下患者的回顾性队列分析。收集的数据包括年龄、事件类型、给予的药物和液体、进行的操作、接收的医院、24 小时和 30 天死亡率以及损伤情况。
最常见的损伤机制是跌倒（33%）、机动车事故（30%）、运动损伤（14%）和浸水伤（12%）。共有 27 名儿童在 30 天内死亡；非创伤病例在死亡病例中比例过高。就任务分工而言，59%的病例涉及严重或明显受伤的儿童。在这些儿童中，97%有创伤机制的儿童直接被转送到儿科创伤中心。此外，81%的儿童在事故现场至少接受了一次直升机紧急医疗服务团队的干预，最常见的干预措施是静脉置管（61%）、晶体液推注（29%）、插管（21%）和静脉镇痛剂给药（15%）。
儿科院前患者可能病情严重，需要紧急重症监护治疗。院前医学培训应包括儿科内容。从业者必须保持在儿童中进行静脉通路、气道管理和提供足够镇痛方面的技能。
