Department of Anaesthesia, Flinders Medical Centre, Adelaide, South Australia, Australia.
MedSTAR Emergency Medical Retrieval Service, Adelaide, South Australia, Australia.
Emerg Med Australas. 2022 Oct;34(5):711-716. doi: 10.1111/1742-6723.13969. Epub 2022 Mar 30.
To assess the performance of an Australian pre-hospital and retrieval medicine (PHRM) service against the National Institute for Health and Care Excellence (NICE) standard which recommends that pre-hospital emergency anaesthesia (PHEA) in trauma patients should be conducted within 45-min of first contact with emergency services.
Retrospective observational study of all adult trauma patients in which PHEA was conducted by the PHRM service covering a 5-year period from January 2015 to December 2019.
Over the 5-year study period, 1509 (22%) of the PHRM service workload comprised primary retrievals from scene. Most 1346 (89%) of these cases had a primary diagnosis of trauma. Of these we have complete data for 328 of the 337 cases requiring a PHEA and 121 (37%) patients received this within the recommended 45-min time frame. The service attended in rapid response vehicles (n = 160, 49%), rotary wing (n = 151, 46%) and fixed wing (n = 17, 5%) transport modalities. For a service covering 983 482 km , the median distance travelled to patients was 35 (16-71) km and the median time to PHEA was 54 (38-80) min.
In a cohort of 337 patients treated by a dedicated PHRM service in South Australia, the median time to PHEA was 54 (38-80) min with only 37% of patients receiving PHEA within 45 min from the activation of the team. Despite differing patient demographics, the percentage of patients receiving PHEA within the recommended time frame was greater than a similar cohort from the UK. However, both data sets still fall short of recommended targets.
评估澳大利亚院前和检索医学（PHRM）服务对英国国家卫生与保健优化研究所（NICE）标准的执行情况，该标准建议创伤患者的院前紧急麻醉（PHEA）应在与急救服务首次接触后的 45 分钟内进行。
回顾性观察研究 2015 年 1 月至 2019 年 12 月期间，PHRM 服务对所有接受 PHEA 的成年创伤患者进行的为期 5 年的研究。
在 5 年的研究期间，PHRM 服务的工作量中有 1509 例（22%）是从现场进行的初步检索。这些病例中大多数（1346 例，89%）的主要诊断为创伤。在这些患者中，我们有完整数据的需要 PHEA 的有 328 例，其中 121 例（37%）在推荐的 45 分钟时间框架内接受了 PHEA。服务采用快速反应车辆（n=160，49%）、旋转翼（n=151，46%）和固定翼（n=17，5%）运输方式。对于覆盖 983482 公里的服务，到患者的中位数距离为 35（16-71）公里，中位数到达 PHEA 的时间为 54（38-80）分钟。
在南澳大利亚由专门的 PHRM 服务治疗的 337 例患者队列中，到达 PHEA 的中位数时间为 54（38-80）分钟，只有 37%的患者在团队激活后 45 分钟内接受 PHEA。尽管患者的人口统计学特征不同，但在推荐时间范围内接受 PHEA 的患者比例高于英国的类似队列。然而，两个数据集仍未达到推荐的目标。
