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直升机紧急医疗服务进行的儿科院外心肺复苏与常规紧急医疗服务相比有附加价值吗?

Pediatric out-of-hospital cardiopulmonary resuscitation by helicopter emergency medical service, does it has added value compared to regular emergency medical service?

作者信息

Moors X R J, Rijs K, Den Hartog D, Stolker R J

机构信息

Department of Pediatric Anesthesiology, Erasmus MC, University Medical Center Rotterdam-Sophia Children's Hospital, P.O. Box 2060, 3015 CN, Rotterdam, The Netherlands.

HEMS, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

Eur J Trauma Emerg Surg. 2018 Jun;44(3):407-410. doi: 10.1007/s00068-017-0815-5. Epub 2017 Jul 15.

Abstract

PURPOSE

To determine the outcome of out-of-hospital (OOH) cardiopulmonary resuscitation (CPR) and the advanced life support (ALS) procedures provided in pediatrics by the Rotterdam Helicopter Emergency Medical Service (HEMS) METHODS: Retrospective evaluation of all pediatric (0-17 years) OOH cardiopulmonary arrests within a 6-year period and attended by the Rotterdam HEMS team.

RESULTS

There were 201 OOH CPRs from October 2008 until October 2014. Endotracheal intubation was performed in 164 cases and done by HEMS in 104 patients (63%), intraosseous/intravenous cannulation 43/27 times, and additional medication given by HEMS in 70 patients (35%). The overall survival rate for OOH CPR was 15%, but in trauma was low. Twenty-seven of the 29 pediatric patients who survived until discharge are neurological well. Although the Dutch nationwide ambulance protocol states intubation, intravenous, or intraosseal excess and medication, in many patients, only HEMS provided additional ALS care.

CONCLUSION

The HEMS brings essential medical expertise in the field not provided by regular emergency medical service. HEMS provide a significant quantity of procedures, obviously needed by the OOH CPR of a pediatric patient.

摘要

目的

确定鹿特丹直升机紧急医疗服务(HEMS)所提供的院外(OOH)儿科心肺复苏(CPR)及高级生命支持(ALS)程序的结果。方法:对鹿特丹HEMS团队在6年期间参与的所有儿科(0至17岁)院外心脏骤停情况进行回顾性评估。

结果

2008年10月至2014年10月期间共有201例院外CPR。164例进行了气管插管,其中104例(63%)由HEMS完成;骨内/静脉插管43/27次;70例(35%)由HEMS给予额外药物治疗。院外CPR的总体生存率为15%,但创伤情况下生存率较低。29例存活至出院的儿科患者中有27例神经功能良好。尽管荷兰全国性的救护车协议规定了插管、静脉或骨内操作及用药,但在许多患者中,只有HEMS提供了额外的ALS护理。

结论

HEMS带来了常规紧急医疗服务所不具备的该领域基本医疗专业知识。HEMS提供了大量儿科患者院外CPR明显所需的程序。

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