Selig H F, Nagele P, Voelckel W G, Trimmel H, Hüpfl M, Lumenta D B, Kamolz L P
Section of Plastic, Aesthetic and Reconstructive Surgery, General Hospital Wr. Neustadt, Wr. Neustadt, Austria.
Department of Anaesthesiology and General Intensive Care and Pain Therapy, Medical University of Vienna, Vienna, Austria.
Eur J Trauma Emerg Surg. 2012 Dec;38(6):651-7. doi: 10.1007/s00068-012-0211-0. Epub 2012 Jul 19.
Data on the epidemiological characteristics of traumatic amputations in prehospital emergency care, especially in the context of air rescue, are scarce. Therefore, we aimed to describe the epidemiology of total and subtotal amputation injuries encountered by the OEAMTC helicopter emergency medical service (HEMS) in Austria, based on an almost nationwide sample.
We retrospectively reviewed all HEMS rescue missions flown for amputation injuries in 2009. Only primary missions were analyzed.
In total, 149 out of 16,100 (0.9 %) primary HEMS rescue missions were for patients suffering from amputation injuries. Among these, HEMS physicians diagnosed 63.3 % (n = 94) total and 36.9 % (n = 55) subtotal amputations, with both groups showing a predominance of male victims (male:female ratios were 8:1 and 6:1, respectively).The highest rate occurred among adults between 45 and 64 years of age (35.6 %, n = 53). The most common causes were working with a circular saw (28.9 %, n = 43) and processing wood (16.8 %, n = 25). The majority of the cases included digital amputation injuries (77.2 %, n = 115) that were mainly related to the index finger (36.2 %, n = 54). One hundred forty patients (94.0 %) showed a total GCS of more than 12. Amputations were most prevalent in rural areas (84.6 %, n = 126) and between Thursday and Saturday (55.0 %, n = 82). The replantation rate after primary air transport was low (28 %).
In the HEMS, amputation injuries are infrequent and mostly not life-threatening. However, HEMS crews need to maintain their focus on providing sufficient and fast primary care while facilitating rapid transport to a specialized hospital. The knowledge of the epidemiological characteristics of amputation injuries encountered in the HEMS gained in this study may be useful for educational and operational purposes.
关于院前急救中创伤性截肢的流行病学特征的数据，尤其是在空中救援背景下的数据稀缺。因此，我们旨在基于几乎覆盖全国的样本，描述奥地利紧急医疗空中救援服务（HEMS）所遇到的完全和不完全截肢损伤的流行病学情况。
我们回顾性分析了2009年因截肢损伤执行的所有HEMS救援任务。仅分析主要任务。
在16100次主要HEMS救援任务中，共有149次（0.9%）是针对截肢损伤患者。其中，HEMS医生诊断出94例（63.3%）为完全截肢，55例（36.9%）为不完全截肢，两组均以男性受害者为主（男女比例分别为8:1和6:1）。最高发生率出现在45至64岁的成年人中（35.6%，n = 53）。最常见的原因是使用圆锯作业（28.9%，n = 43）和木材加工（16.8%，n = 25）。大多数病例包括手指截肢损伤（77.2%，n = 115），主要涉及食指（36.2%，n = 54）。140名患者（94.0%）的格拉斯哥昏迷量表（GCS）总分超过12分。截肢在农村地区最为普遍（84.6%，n = 126），且在周四至周六期间发生率最高（55.0%，n = 82）。初次空中转运后的再植率较低（28%）。
在HEMS中，截肢损伤并不常见，且大多不会危及生命。然而，HEMS工作人员需要始终专注于提供充分且快速的初级护理，同时促进迅速转运至专科医院。本研究中获得的关于HEMS中遇到的截肢损伤流行病学特征的知识可能对教育和操作目的有用。
