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澳大利亚航空医疗救援服务中的农村和偏远地区插管:一项回顾性队列研究。

Rural and Remote Intubations in an Australian Air Medical Retrieval Service: A Retrospective Cohort Study.

机构信息

Emergency Department, Gold Coast University Hospital, Southport, Queensland, Australia; LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia; Bond University, Gold Coast, Queensland, Australia; Griffith University, Southport, Gold Coast, Queensland, Australia.

LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia.

出版信息

Air Med J. 2021 Jul-Aug;40(4):251-258. doi: 10.1016/j.amj.2021.03.006. Epub 2021 Apr 16.

Abstract

OBJECTIVE

Critically unwell patients in rural and remote areas of Queensland, Australia, often require airway management with rapid sequence intubation before retrieval to a tertiary center. Retrieval Services Queensland coordinate retrievals and support rural hospitals, including via telehealth. This study compared the demographics of patients intubated by a retrieval team including a LifeFlight Retrieval Medicine doctor with those intubated by the local hospital team.

METHODS

This was a retrospective cohort study of patients intubated in hospitals in Queensland, Australia, requiring subsequent air medical retrieval between January and December 2019. The data collected included the time of day, mission priority, geographic location, diagnosis, and failure/assistance with intubation. Descriptive statistics were complemented by regression analyses.

RESULTS

In 2019, 684 patients were intubated in hospitals in Queensland, Australia, requiring air medical retrieval by a team including a LifeFlight Retrieval Medicine doctor. One hundred thirty-one (19.2%) were intubated by the retrieval team, and 553 (80.8%) were intubated by the hospital team. In the most rural and remote areas, 64 (43.2%) of the patients were intubated by the retrieval team compared with 84 (56.8%) by the hospital team.

CONCLUSION

A retrieval team is more likely to intubate patients in remote hospitals in Queensland, Australia. Remote hospitals should be given preference for dispatch of the retrieval team for assistance with critical patients.

摘要

目的

在澳大利亚昆士兰州的农村和偏远地区,情况危急的患者通常需要在被送往三级中心之前进行快速序贯插管。昆士兰救援服务协调救援工作并为农村医院提供支持,包括通过远程医疗。本研究比较了由救援团队(包括 Lifeflight 救援医学医生)进行插管的患者与由当地医院团队进行插管的患者的人口统计学特征。

方法

这是一项回顾性队列研究,研究对象为 2019 年 1 月至 12 月期间在澳大利亚昆士兰州医院插管、需要后续航空医疗救援的患者。收集的数据包括插管时间、任务优先级、地理位置、诊断以及插管失败/辅助情况。描述性统计数据辅以回归分析。

结果

2019 年,在澳大利亚昆士兰州的医院中,有 684 名患者需要由包括 Lifeflight 救援医学医生在内的团队进行航空医疗救援。其中 131 名(19.2%)由救援团队进行插管,553 名(80.8%)由医院团队进行插管。在最偏远的地区,64 名(43.2%)患者由救援团队进行插管,而由医院团队进行插管的患者为 84 名(56.8%)。

结论

在澳大利亚昆士兰州,救援团队更有可能在偏远医院为患者进行插管。对于需要重症患者援助的偏远医院,应优先派遣救援团队。

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