Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK; Great North Air Ambulance Service, Eaglescliffe, UK.
Nottingham University Hospitals NHS Trust, Nottingham, UK; The Air Ambulance Service, Rugby, UK.
Br J Anaesth. 2020 May;124(5):571-578. doi: 10.1016/j.bja.2020.01.029.
Pre-hospital emergency anaesthesia (PHEA) is frequently required for injured patients. National Institute for Health and Care Excellence (NICE) quality standards state that PHEA should be delivered within 45 min of an emergency call. We investigated whether there is geo-temporal variation in service provision to the UK population.
We retrospectivly audited the time of day when PHEA is provided by UK Helicopter Emergency Medical Services (HEMS), by recording PHEA provision on a randomly selected week and weekend day in 2018. Pre-hospital emergency anaesthesia in the United Kingdom: an observational cohort study retrospectively assessed the time from emergency call to pre-hospital emergency anaesthesia delivery by HEMS during a 1 yr period from April 2017 to March 2018. The population coverage likely to receive pre-hospital emergency anaesthesia in accord with NICE guidelines was estimated by integrating population data with the median time to PHEA, hours of service provision, geographic location, and transport modality.
On a weekday 20 HEMS units (comprising from four to 31 enhanced care teams) were estimated to be able to meet NICE guidelines for delivery of PHEA to a poulation of 6.6-35.2 million individuals (at times of minimum and maximal staffing, respectively). At the weekend, 17 HEMS units (comprising from 5 to 28 enhanced care teams) were estimated to be able to meet NICE guidelines for PHEA deliveryto a population of 6.8-34.1 million individuals (minimum and maximal staffing, respectively).
There is marked geo-temporal variation in the ability of HEMS organisations to deliver pre-hospital emergency anaesthesia in the UK.
受伤患者经常需要进行院前急救麻醉（PHEA）。国家卫生与保健卓越研究所（NICE）质量标准规定，PHEA 应在紧急呼叫后 45 分钟内提供。我们调查了向英国人口提供服务是否存在地理时间变化。
我们回顾性地审核了英国直升机紧急医疗服务（HEMS）提供 PHEA 的时间，方法是在 2018 年随机选择的一周和周末记录 PHEA 的提供情况。英国院前急救麻醉：一项观察性队列研究回顾性评估了从紧急呼叫到 HEMS 提供院前急救麻醉的时间，该研究在 2017 年 4 月至 2018 年 3 月期间进行了 1 年。通过将人口数据与 PHEA 的中位数时间、服务提供时间、地理位置和运输方式相结合，估计了符合 NICE 指南的院前急救麻醉的人口覆盖范围。
在工作日，估计有 20 个 HEMS 单位（由四到 31 个强化护理团队组成）能够按照 NICE 指南为 660 万至 3520 万（分别为最小和最大人员配置时）个人提供 PHEA。在周末，估计有 17 个 HEMS 单位（由五到 28 个强化护理团队组成）能够按照 NICE 指南为 680 万至 3410 万（分别为最小和最大人员配置时）个人提供 PHEA。
英国 HEMS 组织提供院前急救麻醉的能力存在明显的地理时间变化。
