Ishikawa Kouhei, Omori Kazuhiko, Takeuchi Ikuto, Jitsuiki Kei, Yoshizawa Toshihiko, Ohsaka Hiromichi, Nakao Yasuaki, Yamamoto Takuji, Yanagawa Youichi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan.
Am J Emerg Med. 2017 Apr;35(4):543-547. doi: 10.1016/j.ajem.2016.12.007. Epub 2016 Dec 10.
We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system.
We retrospectively investigated all of the patients with non-traumatic SAH who were transported by a Dr. Heli between January 2010 and March 2016. The subjects were divided into two groups: the Scene group included subjects who were evacuated from the scene by a Dr. Heli, while the Interhospital group included subjects who were transported by a ground ambulance to a nearby medical facility and then transported by a Dr. Heli to a single tertiary center.
The systolic blood pressure, ratio of cardiac arrest, and Fisher classification values of the patients in the Scene group were significantly greater than those in the Interhospital group. The Glasgow Coma Scale in the Scene group was significantly lower than that in the Interhospital group. After excluding the patients with cardiac arrest, the Glasgow Coma Scale scores of the patients in the two groups did not differ to a statistically significant extent during, before or after transportation. There were no significant differences in Glasgow Outcome Scores or the survival ratio of the two groups, even when cardiac arrest patients were included.
The present study indirectly suggests the safety of using a Dr. Heli to evacuate SAH patients from the scene.
我们调查了使用医生直升机(Dr. Heli)服务从现场转运的蛛网膜下腔出血(SAH)患者的生命体征变化及最终结局,并与仅使用医生直升机(Dr. Heli)服务进行院间转运的患者进行比较,以研究该系统的安全性。
我们回顾性调查了2010年1月至2016年3月期间由Dr. Heli转运的所有非创伤性SAH患者。研究对象分为两组:现场组包括由Dr. Heli从现场转运的患者,而院间组包括由地面救护车转运至附近医疗机构,然后再由Dr. Heli转运至单一三级中心的患者。
现场组患者的收缩压、心脏骤停发生率和Fisher分级值显著高于院间组。现场组的格拉斯哥昏迷量表评分显著低于院间组。排除心脏骤停患者后,两组患者在转运期间、转运前或转运后的格拉斯哥昏迷量表评分在统计学上无显著差异。即使纳入心脏骤停患者,两组的格拉斯哥预后评分或生存率也无显著差异。
本研究间接表明了使用Dr. Heli从现场转运SAH患者的安全性。