Medical Corps, Israeli Defense Forces, Tel-Hashomer, Israel (AG, DE, JC, SK, EA, SS); Department of Internal Medicine "B", Rambam Health Care Campus, Haifa, Israel (DE); Department of Emergency Medicine, Leon and Mathilde Recanati School for Community Health Professions, Ben Gurion University of the Negev, Beer-Sheva, Israel (JC); Pediatric Emergency Department, Rambam Health Care Campus, Haifa, Israel (IS); Rappaport Faculty of Medicine, Technion-Institute of Technology, Haifa, Israel; (IS); Medical Intensive Care Unit, Rambam Health Care Campus, Haifa, Israel (AM).
Prehosp Emerg Care. 2021 May-Jun;25(3):397-403. doi: 10.1080/10903127.2020.1757180. Epub 2020 May 1.
The objective of this study was to evaluate the emergency care provided by the Israeli Military Airborne Combat Evacuation Unit (MACEU) during helicopter winching operations. A retrospective cohort study was performed of all patients rescued by winching by the MACEU between December 2011 and October 2018. Data were extracted from the electronic medical records of the unit registry. The data collected included helicopter type, scene times, demographics, mechanism of injury, interventions, medications, and survival. During the study period, 208 civilians with a mean age of 36.8 ± 19.2 years were evacuated from inaccessible areas, 192 were from difficult terrain, 10 from sea vessels, and 5 from floods. All patients were winched up with a crewmember. No patient or crewmember was injured during winching. Overall, 156/208 (75%) had a traumatic injury, and 52/208 (25%) had a medical emergency. Sikorsky UH-60 "BlackHawk" helicopters and Sikorsky CH-53 "Sea Stallion" helicopters were used in 179 and 28 operations, respectively. Eighteen different procedures were performed by the medical personnel of the unit on scene and en route. The most performed procedures were peripheral vascular access establishment (60.6%), fluids administration (57.7%), oxygen supplementation (42.8%), analgesia (39.9%) and spine immobilization (37.5%). On scene, none of the patients was treated with a physician-only intervention. Thirty/208 (14.5%) patients were winched-up in darkness conditions. Eleven/208 (5.3%) apneic breathing patients were winched up ventilated by a crewmember. All the six patients who had oxygen saturation ≥89% after entrance into the cabin, survived. The reported MACEU experience provides useful information on the clinical characteristics, medical interventions, and outcomes of patients rescued using a winching operation. Study findings emphasize the importance of airway management and ventilation during winching.
本研究旨在评估以色列军事空降急救单位（MACEU）在直升机绞车救援行动中提供的紧急医疗服务。采用回顾性队列研究方法，分析 2011 年 12 月至 2018 年 10 月期间 MACEU 通过绞车救援的所有患者。从单位登记册的电子病历中提取数据。收集的数据包括直升机类型、现场时间、人口统计学特征、损伤机制、干预措施、药物治疗和生存情况。在研究期间，208 名平民被从无法到达的地区通过绞车救援上来，平均年龄为 36.8±19.2 岁，其中 192 人来自困难地形，10 人来自船只，5 人来自洪水。所有患者均由机组人员绞车救援。绞车救援过程中没有患者或机组人员受伤。总体而言，208 名患者中 156 名（75%）有创伤性损伤，52 名（25%）有医疗紧急情况。使用了 179 次 Sikorsky UH-60“黑鹰”直升机和 28 次 Sikorsky CH-53“海上种马”直升机。单位的医疗人员在现场和途中共进行了 18 种不同的程序。执行最多的程序是外周血管通路建立（60.6%）、输液（57.7%）、氧补充（42.8%）、镇痛（39.9%）和脊柱固定（37.5%）。在现场，没有患者接受过只有医生才能进行的干预。30/208（14.5%）名患者在黑暗条件下被绞车救援。11/208（5.3%）名呼吸暂停的患者由机组人员进行通气绞车救援。所有 6 名进入机舱后血氧饱和度≥89%的患者均存活。报告的 MACEU 经验提供了关于使用绞车救援的患者的临床特征、医疗干预措施和结局的有用信息。研究结果强调了在绞车救援过程中气道管理和通气的重要性。
