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日本伊豆半岛合作医疗系统在治疗减压病方面的意义。

The Significance of a Cooperative Medical System for Treating Decompression Illness on the Izu Peninsula in Japan.

作者信息

Yanagawa Youichi, Onitsuka Mika, Nozawa Yoko, Nagasawa Hiroki, Ikuto Takeuchi, Jitsuiki Kei, Madokoro Shunsuke, Ohsaka Hiromichi, Ishikawa Kouhei, Omori Kazuhiko

机构信息

Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan.

Department of Acute Critical Care Medicine, Juntendo Shizuoka Hospital, Izunokuni City, Japan.

出版信息

Wilderness Environ Med. 2019 Sep;30(3):268-273. doi: 10.1016/j.wem.2019.05.005. Epub 2019 Jul 22.

Abstract

INTRODUCTION

In 2011, our hospital on the Izu peninsula began to hold meetings to discuss how to manage patients with decompression illness (DCI) to establish a cooperative medical system. We retrospectively investigated the influence of these meetings and the changes subsequently effected.

METHODS

A medical chart review was retrospectively performed to investigate all cases between January 2005 and December 2017 in which the transport of patients with DCI via a physician-staffed helicopter emergency medical service (HEMS) was attempted. The patients were divided into 2 groups: the preprogram group and the postprogram group.

RESULTS

There were 63 patients in the preprogram group and 65 in the postprogram group. There were no cases in which a patient's symptoms deteriorated during transportation by the HEMS. The frequency of dispatch to the scene for direct evacuation in the postprogram group (86%) was greater than that in the preprogram group (74%), but the difference was not statistically significant (P=0.09). In the postprogram group, the duration of activities at the scene or the first aid hospital was significantly shorter in comparison to the preprogram group (P=0.01).

CONCLUSIONS

This retrospective study revealed simultaneity between the introduction of the yearly meetings and a reduced duration of the HEMS staff's activity at either the scene or the first aid hospital.

摘要

引言

2011年,我们位于伊豆半岛的医院开始召开会议,讨论如何管理减压病(DCI)患者,以建立合作医疗系统。我们回顾性调查了这些会议的影响以及随后产生的变化。

方法

对2005年1月至2017年12月期间所有尝试通过配备医生的直升机紧急医疗服务(HEMS)转运减压病患者的病例进行回顾性病历审查。将患者分为两组:项目前组和项目后组。

结果

项目前组有63例患者,项目后组有65例患者。在通过HEMS转运过程中,没有患者症状恶化的情况。项目后组直接疏散到现场的派遣频率(86%)高于项目前组(74%),但差异无统计学意义(P=0.09)。与项目前组相比,项目后组在现场或急救医院的活动持续时间明显更短(P=0.01)。

结论

这项回顾性研究揭示了年度会议的引入与HEMS工作人员在现场或急救医院的活动持续时间缩短之间的同步性。

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