Division of Family Medicine, Department of Community Medicine, Landseed International Hospital, Taoyuan, Taiwan.
Landseed Medical Clinic at Taiwan Taoyuan International Airport, Taoyuan, Taiwan.
Front Public Health. 2021 Jul 23;9:663108. doi: 10.3389/fpubh.2021.663108. eCollection 2021.
Limited information is available covering all medical events managed by the airport-based outreach medical service. This study explores the clinical demand for emergency medical outreach services at Taoyuan International Airport (TIA), Taiwan. Electronic medical records collected from TIA medical outreach services from 2017 to 2018, included passengers' profiles, flight information, events location, chief complaints, diagnosis (using ICD-9 -CM codes), and management outcomes. Medical events distribution was stratified by location and ages, and were compared statistically. Among 1,501 eligible records, there were 81.8% ground-based emergency medical events (GBME), 16.9% in-flight medical events (IFME) managed after scheduled landing, and 1.3% IFME leading to unscheduled diversion or re-entry to TIA. The top three GBME diagnoses were associated with neurological (23.3%), gastrointestinal (21.2%), and trauma-related (19.3%) conditions. The top three IFME diagnosis that prompted unscheduled landings via flight diversion or re-entry were neurological (47.4%), psychological (15.8%), and cardiovascular (10.5%). The chief complaints that prompted unscheduled landings were mostly related to neurological (42.1%), cardiovascular (26.3%), and out-of-hospital cardiac arrest (OHCA) (10.5%) symptoms. A higher frequency of IFME events due to dermatologic causes in patients aged ≤ 18 years compared with adults and older adults (19 vs. 1.5% and 0, respectively); and a higher frequency of IFME due to cardiovascular causes in adults ≥ 65 years compared with patients aged ≤ 65 (15.1 vs. 9%). Among all IFME patients, six out-of-hospital deaths occurred among passengers from scheduled landings and two deaths occurred among 18 IFME passengers who were transferred to local hospitals from flight diversion or re-entry. A statistically significant difference in outcomes and short-term follow-up status was found between patients with IFME and those with GBME ( < 0.001). Ground-based emergency medical events exceeded in-flight medical events at TIA. The most frequent events were related to neurological, gastrointestinal symptoms, or trauma. Results of this study may provide useful information for training medical outreach staff and preparing medical supplies to meet the clinical demand for airport medical outreach services.
有关机场外展医疗服务管理的所有医疗事件的信息有限。本研究探讨了桃园国际机场（TIA）紧急医疗外展服务的临床需求。 从 2017 年至 2018 年，从 TIA 医疗外展服务中收集了电子病历，包括乘客的个人资料、航班信息、事件地点、主要投诉、诊断（使用 ICD-9-CM 代码）和管理结果。按位置和年龄对医疗事件进行分层，并进行统计学比较。 在 1501 份合格记录中，有 81.8%的地面紧急医疗事件（GBME）、16.9%的飞行中医疗事件（IFME）在计划降落后进行管理，以及 1.3%的 IFME 导致非计划改道或返回 TIA。GBME 的前三大诊断与神经（23.3%）、胃肠道（21.2%）和与创伤相关的（19.3%）疾病有关。通过飞行改道或返回导致非计划降落的 IFME 的前三大诊断是神经（47.4%）、心理（15.8%）和心血管（10.5%）。导致非计划降落的主要投诉大多与神经（42.1%）、心血管（26.3%）和院外心脏骤停（OHCA）（10.5%）症状有关。与成年人和老年人（19%和 0%）相比，≤18 岁的 IFME 患者因皮肤科原因导致 IFME 事件的频率更高；与≤65 岁的患者相比，≥65 岁的成年人因心血管原因导致 IFME 的频率更高（15.1%比 9%）。在所有 IFME 患者中，6 名来自计划降落的乘客在院外死亡，2 名来自飞行改道或返回的 18 名 IFME 乘客在当地医院死亡。IFME 患者与 GBME 患者的结果和短期随访状态存在统计学显著差异（<0.001）。 TIA 的地面紧急医疗事件超过飞行中医疗事件。最常见的事件与神经、胃肠道症状或创伤有关。本研究结果可为培训医疗外展人员和准备医疗用品以满足机场医疗外展服务的临床需求提供有用信息。
