Fjaeldstad Alexander, Kirk Morten Hasager, Knudsen Lars, Bjerring Jesper, Christensen Erika F
Research Department, Prehospital Emergency Medical Services, Region of Central Jutland, Aarhus, Denmark.
Dan Med J. 2013 Jul;60(7):A4666.
Since 2007, the number of Danish emergency departments has decreased from 44 to 21. Longer distances to specialized treatment have increased the demand for advanced prehospital treatment. A Danish 24/7 Helicopter Emergency Medical System (HEMS) project in western Denmark was initiated on 6 January 2011. The HEMS provides prehospital care delivered by a specialized anaesthesiologist. This study evaluated the effect of HEMS on the time to treatment by a physician (time-to-doctor) and the time from a 112 emergency call to arrival at the highly specialized centre (time-to-centre) for patients with ST-elevation myocardial infarction (STEMI) or severe injury (Injury Severity Score > 15).
In this prospective study with a matched historical control group, the time-to-doctor and the time-to-centre for patients with STEMI or severe injury transported by HEMS were compared with geographically matched patients with the same diagnoses and who were transported by ambulance.
Time-to-centre was reduced from 102 to 84 min. for STEMI and from 322 to 97 min. for severely injured patients after HEMS implementation. HEMS did not substantially reduce time-to-doctor, mainly because of increased availability of physician-staffed cars. In 56% of cases, HEMS was dispatched secondarily more than 30 min. after the ambulance had been dispatched.
Using HEMS reduced time to arrival at a highly specialized centre for patients with STEMI or severe injury. Simultaneous dispatch of an ambulance and HEMS shows potential for further reduction in the time-to-centre and the time-to-doctor.
not relevant.
The trial is registered at the Danish Data Protection Agency.
自2007年以来,丹麦急诊科的数量已从44个减少至21个。前往专科治疗的距离变长,增加了对高级院前治疗的需求。2011年1月6日,丹麦在日德兰半岛启动了一个全天候直升机紧急医疗系统(HEMS)项目。该HEMS由一名专业麻醉师提供院前护理。本研究评估了HEMS对ST段抬高型心肌梗死(STEMI)或重伤(损伤严重度评分>15)患者的医生治疗时间(就医时间)以及从拨打112急救电话到抵达高度专科中心的时间(到中心时间)的影响。
在这项设有匹配历史对照组的前瞻性研究中,将由HEMS转运的STEMI或重伤患者的就医时间和到中心时间,与地理匹配的、诊断相同且由救护车转运的患者进行比较。
实施HEMS后,STEMI患者的到中心时间从102分钟缩短至84分钟,重伤患者从322分钟缩短至97分钟。HEMS并未大幅缩短就医时间,主要原因是配备医生的汽车可用性增加。在56%的病例中,HEMS在救护车派出30分钟以上后才被二次派出。
使用HEMS可缩短STEMI或重伤患者抵达高度专科中心的时间。同时派出救护车和HEMS显示出进一步缩短到中心时间和就医时间的潜力。
不相关。
该试验已在丹麦数据保护局注册。