Sugita Mariko, Higami Shigeo, Inoue Shigeaki, Morita Seiji, Nakagawa Yoshihide, Inokuchi Sadaki
Department of Emergency and Critical Care Medicine Tokai University Scool of Medicine Isehara Japan.
Acute Med Surg. 2017 Apr 24;4(3):246-250. doi: 10.1002/ams2.255. eCollection 2017 Jul.
Various critical cases have been transported since the use of the Kanagawa Helicopter Emergency Medical Service (HEMS) started at Tokai University Hospital (Isehara, Japan) in 2002, including cases of acute poisoning. We analyzed the characteristics of acute poisoning cases conveyed by the HEMS.
Kanagawa HEMS conveyed 3,814 cases from July 2002 to March 2013, and acute drug and poison intoxication was diagnosed in 131 of these cases. We undertook a descriptive statistical study of these cases.
The causative agent was found to be psychiatric prescription drugs in 39.7% of cases, pesticides in 29.7%, alcohol in 8.4%, analgesics in 5.3%, detergent or bleach in 6.1%, oil, natural gas, or thinner in 4.6%, and others in 6.1%. At HEMS contact, systolic blood pressure was less than 90 mmHg in 18.3% of cases, and 40.2% were in coma. Endotracheal intubation was carried out in 44.5% of cases, and 6.9% died within 24 h of hospital admission. The cases of poisoning that we transported in the HEMS were often in shock and/or coma on arrival at the field, and rapid endotracheal intubation was required in nearly half of them, as many were in a serious condition.
We believe that outcomes were more likely to be improved by appropriate early treatment by the HEMS. It will be necessary to further compare the ambulance service with the HEMS to evaluate their efficacy in the future.
自2002年日本东海大学医院(伊势原)启用神奈川直升机紧急医疗服务(HEMS)以来,已转运了各种危急病例,包括急性中毒病例。我们分析了由HEMS转运的急性中毒病例的特征。
2002年7月至2013年3月,神奈川HEMS共转运了3814例病例,其中131例被诊断为急性药物和毒物中毒。我们对这些病例进行了描述性统计研究。
发现致病因素为精神科处方药的病例占39.7%,农药占29.7%,酒精占8.4%,镇痛药占5.3%,洗涤剂或漂白剂占6.1%,油、天然气或稀释剂占4.6%,其他占6.1%。在HEMS接触时,18.3%的病例收缩压低于90mmHg,40.2%的病例处于昏迷状态。44.5%的病例进行了气管插管,6.9%的病例在入院后24小时内死亡。我们通过HEMS转运的中毒病例在到达现场时往往处于休克和/或昏迷状态,近一半的病例需要迅速进行气管插管,因为许多病例病情严重。
我们认为,通过HEMS进行适当的早期治疗更有可能改善预后。未来有必要进一步比较救护车服务和HEMS,以评估它们的疗效。