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欧洲直升机紧急医疗服务活动的横断面调查:一项可行性研究。

Cross-sectional investigation of HEMS activities in Europe: a feasibility study.

作者信息

Di Bartolomeo Stefano, Gava Paolo, Truhlář Anatolij, Sandberg Mårten

机构信息

Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, P.O. Box 94, 1441 Drøbak, Norway ; Azienda Ospedaliero Universitaria di Udine, Piazza SM Misericordia 15, 33100 Udine, Italy.

Department of Research and Development, Norwegian Air Ambulance Foundation, Holterveien 24, P.O. Box 94, 1441 Drøbak, Norway.

出版信息

ScientificWorldJournal. 2014;2014:201570. doi: 10.1155/2014/201570. Epub 2014 Nov 30.

Abstract

OBJECTIVES

To gather information on helicopter emergency medical services (HEMSs) activities across Europe.

METHODS

Cross-sectional data-collection on daily (15 November 2013) activities of a sample of European HEMSs. A web-based questionnaire with both open and closed questions was used, developed by experts of the European Prehospital Research Alliance (EUPHOREA).

RESULTS

We invited 143 bases from 11 countries; 85 (60%) reported base characteristics only and 73 (51%) sample-day data too. The variety of base characteristics was enormous; that is, the target population ranged from 94.000 to 4.500.000. Of 158 requested primary missions, 62 (0.82 per base) resulted in landing. Cardiac aetiology (36%) and trauma (36%) prevailed, mostly of life-threatening severity (43%, 0.64 per mission). Had HEMS been not dispatched, patients would have been attended by another physician in 67% of cases, by paramedics in 24%, and by nurses in 9%. On-board physicians estimated to have caused a major decrease of death risk in 47% of missions, possible decrease in 22%, minor benefit in 17%, no benefit in 11%, and damage in 3%. Earlier treatment and faster transport to hospital were the main reasons for benefit. The most frequent therapeutic procedure was drug administration (78% of missions); endotracheal intubation occurred in 25% of missions and was an option hardly offered by ground crews.

CONCLUSIONS

The study proved feasible, establishing an embryonic network of European HEMS. The participation rate was low and limits the generalizability of the results. Fortunately, because of its cross-sectional characteristics and the handy availability of the web platform, the study is easily repeatable with an enhanced network.

摘要

目的

收集有关欧洲直升机紧急医疗服务(HEMS)活动的信息。

方法

对欧洲HEMS样本的日常(2013年11月15日)活动进行横断面数据收集。使用了由欧洲院前研究联盟(EUPHOREA)专家开发的基于网络的问卷,该问卷包含开放式和封闭式问题。

结果

我们邀请了来自11个国家的143个基地;85个(60%)仅报告了基地特征,73个(51%)还报告了样本日数据。基地特征的差异很大;也就是说,目标人群从94000到4500000不等。在158次请求的主要任务中,62次(每个基地0.82次)成功降落。心脏病因(36%)和创伤(36%)占主导,大多为危及生命的严重程度(43%,每次任务0.64次)。如果未派遣HEMS,67%的病例将由另一名医生诊治,24%由护理人员诊治,9%由护士诊治。机上医生估计在47%的任务中使死亡风险大幅降低,22%可能降低,17%有轻微益处,11%无益处,3%有损害。早期治疗和更快送往医院是获益的主要原因。最常见的治疗程序是药物给药(78%的任务);气管插管发生在25%的任务中,而地面人员很少提供这种选择。

结论

该研究证明可行,建立了欧洲HEMS的初步网络。参与率较低,限制了结果的普遍性。幸运的是,由于其横断面特征和网络平台的便捷可用性,该研究可以通过扩大网络轻松重复进行。

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