Holland Seth R, Apodaca Amy, Mabry Robert L
U.S. Army Institute for Surgical Research, 3698 Chambers Pass, Building 3611, Fort Sam Houston, TX 78234-6315.
Mil Med. 2013 May;178(5):529-36. doi: 10.7205/MILMED-D-12-00286.
Determine if a higher level of Army flight medic (AFM) training was associated with improved physiological state on arrival to a combat support hospital (CSH).
A retrospective study comparing casualties who were evacuated by two AFM units with only Emergency Medical Technicians-Basic (EMT-Bs) to an Army National Guard unit with Critical Care Flight Paramedics (CCFPs) in Afghanistan with an injury severity score >16 in different time periods looking at their 48-hour mortality, hematocrit (HCT), base deficit (BD), oxygen saturation (SpO2), and physiological parameters on arrival to the CSH.
The CCFP group had better HCT [36.5 (8.8)] than the EMT-B group [33.1 (11.4); p ≤ 0.001]. BD and SpO2 were better in the CCFP group [-3.2 (4.7)]/[97.8 (4.8)] than the EMT-B group [-4.4 (5.5)]/[96.3 (10.9)] [p ≤ 0.014]. The CCFP group had a 72% lower estimated risk ratio of mortality with an associated improvement in 48-hour survivability of 4.9% versus 15.8% for the EMT-B-group.
There is a statistically significant improvement in the HCT, BD, SpO2, and 48-hour survivability at the CSH in the cohort transported by the CCFP group when compared to the cohort transported by the EMT-B group.
确定更高水平的陆军飞行医护兵（AFM）培训是否与抵达战斗支援医院（CSH）时生理状态的改善相关。
一项回顾性研究，比较在不同时间段被两个仅配备基础急救医疗技术员（EMT-B）的AFM单位后送至阿富汗一个配备重症护理飞行护理人员（CCFP）的陆军国民警卫队单位的伤员，这些伤员的损伤严重度评分>16，观察他们抵达CSH时的48小时死亡率、血细胞比容（HCT）、碱缺失（BD）、血氧饱和度（SpO2）及生理参数。
CCFP组的HCT[36.5（8.8）]优于EMT-B组[33.1（11.4）；p≤0.001]。CCFP组的BD和SpO2[-3.2（4.7）]/[97.8（4.8）]优于EMT-B组[-4.4（5.5）]/[96.3（10.9）][p≤0.014]。CCFP组的估计死亡风险比低72%，48小时生存率相关改善为4.9%，而EMT-B组为15.8%。
与EMT-B组运送的队列相比，CCFP组运送的队列在CSH的HCT、BD、SpO2及48小时生存率方面有统计学显著改善。
