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[救援直升机的任务范围。德国南部城市地区过去25年的变化]

[Spectrum of missions for a rescue helicopter. Changes in a south German urban area over the last 25 years].

作者信息

Viergutz T, Rohrer O, Weiss C, Braun J, Kalenka A

机构信息

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland,

出版信息

Anaesthesist. 2014 Dec;63(12):932-41. doi: 10.1007/s00101-014-2380-1. Epub 2014 Sep 18.

Abstract

BACKGROUND

Over the past decade the number of air rescue missions has increased continuously. The reasons for this are still discussed at great length. In addition to the demographic changes to becoming an increasingly older and sicker society, the political reform in the healthcare system with a simultaneous reduction and concentration of hospitals and formation of centers is also under discussion.

AIM

The key questions to be answered are, therefore, can the increasing demands on the emergency physician really be explained by an increasing number of severely ill and injured patients? Is a proportion of the missions really not indicated because they do not involve immediately life-threatening "acute medical" emergencies and are caused by a lack of alternative paramedical service infrastructures, unavailability of a general practitioner or the only temporary availability of medical on-call standby services?

MATERIAL AND METHODS

This study therefore analyzed the alterations of a possible change with respect to the spectrum of missions and the utilization of air rescue services in the metropolitan area of Stuttgart. All primary missions of the rescue helicopter (RTH) "Christoph 41" (based in Leonberg) from 2006 to 2011 were included in the study and compared to the data from 1987 to 1992.

RESULTS

The indications for missions and the spectrum of patients for the RTH Christoph 41 have changed over the last 25 years. The proportion of emergency trauma cases has significantly decreased and missions for non-trauma cases have increased. The proportion of patients with life-threatening conditions has increased. Despite the change in the spectrum of missions, emergency physicians are confronted with a greater number of patients with life-threatening conditions than 25 years ago. The patients treated were on average clearly older than the patients who were treated by the air rescue service 25 years ago.

CONCLUSION

The changes in the spectrum of missions up to more emergencies involving non-trauma patients and older patients must be taken into consideration during training and advanced training.

摘要

背景

在过去十年中,空中救援任务的数量持续增加。对此原因仍在进行深入讨论。除了人口结构变化导致社会日益老龄化且疾病增多外,医疗保健系统的政治改革以及医院数量的同时减少和集中化以及中心的形成也在讨论之中。

目的

因此,需要回答的关键问题是,对急诊医生日益增长的需求真的可以用重症和受伤患者数量的增加来解释吗?是否有一部分任务实际上并不必要,因为它们不涉及立即危及生命的“急性医疗”紧急情况,而是由于缺乏替代的辅助医疗服务基础设施、全科医生不可用或医疗随叫随到待命服务仅临时可用?

材料与方法

因此,本研究分析了斯图加特大都市区任务范围和空中救援服务利用方面可能的变化。纳入了2006年至2011年救援直升机(RTH)“克里斯托夫41号”(基地位于莱昂贝格)的所有主要任务,并与1987年至1992年的数据进行比较。

结果

在过去25年中,RTH克里斯托夫41号的任务指征和患者范围发生了变化。急诊创伤病例的比例显著下降,非创伤病例的任务增加。危及生命状况患者的比例有所增加。尽管任务范围发生了变化,但与25年前相比,急诊医生面对的危及生命状况的患者数量更多。接受治疗的患者平均明显比25年前接受空中救援服务治疗的患者年龄更大。

结论

在培训和进修过程中,必须考虑到任务范围的变化,即更多涉及非创伤患者和老年患者的紧急情况。

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