Center for Prehospital and Emergency Research, Department of Clinical Medicine, Aalborg University and Aalborg University Hospital, Aalborg, Denmark.
Unit of Clinical Biostatistics, Aalborg University Hospital, Aalborg, Denmark.
Ann Emerg Med. 2022 Aug;80(2):143-153. doi: 10.1016/j.annemergmed.2022.03.024. Epub 2022 May 5.
To examine the diagnostic pattern, level of severity of illness or injuries, and mortality among children for whom a physician-staffed helicopter emergency medical service (HEMS) was dispatched.
Population-based cohort study including patients aged less than 16 years treated by the Danish national HEMS from October 1, 2014, to September 30, 2018. Diagnoses were retrieved from inhospital medical records, and the severity of illness or injuries was assessed by a severity score on scene, administration of advanced out-of-hospital care, need for intensive care in a hospital, and mortality.
In total, 651 HEMS missions included pediatric patients aged less than 1 year (9.2%), 1 to 2 years (29.0%), 3 to 7 years (28.3%), and 8 to 15 years (33.5%). A third of the patients had critical emergencies (29.6%), and for 20.1% of the patients, 1 or more out-of-hospital interventions were performed: intubation, mechanical chest compressions, intraosseous vascular access, blood transfusion, chest tube insertion, and/or ultrasound examination. Among the 525 patients with hospital follow-up, the most frequent hospital diagnoses were injuries (32.2%), burns (11.2%), and respiratory diseases (7.8%). Within 24 hours of the mission, 18.1% of patients required intensive care. Twenty-nine patients (5.1%, 95% confidence interval [CI] 3.6 to 7.3) died either on or within 1 day of the mission, and the cumulative 30-day mortality was 35 of 565 (6.2%, 95% CI 4.5 to 8.5) (N=565 first-time missions).
On Danish physician-staffed HEMS missions, 1 in 5 pediatric patients required advanced out-of-hospital care. Among hospitalized patients, nearly one-fifth of the patients required immediate intensive care and 6.2% died within 30 days of the mission.
研究派遣医生配备的直升机紧急医疗服务（HEMS）的儿童的诊断模式、疾病严重程度或损伤程度以及死亡率。
本研究为基于人群的队列研究，纳入了 2014 年 10 月 1 日至 2018 年 9 月 30 日期间接受丹麦国家 HEMS 治疗的年龄小于 16 岁的患者。诊断结果从住院病历中提取，疾病严重程度或损伤程度通过现场严重程度评分、高级院外护理的应用、需要在医院接受重症监护以及死亡率进行评估。
共 651 次 HEMS 任务包括年龄小于 1 岁（9.2%）、1-2 岁（29.0%）、3-7 岁（28.3%）和 8-15 岁（33.5%）的儿科患者。三分之一的患者为危急重症（29.6%），20.1%的患者接受了 1 项或多项院外干预：插管、机械胸外按压、经皮骨髓腔穿刺、输血、胸腔引流管插入和/或超声检查。在 525 例有住院随访的患者中，最常见的医院诊断为损伤（32.2%）、烧伤（11.2%）和呼吸系统疾病（7.8%）。在任务后的 24 小时内，18.1%的患者需要重症监护。29 例患者（5.1%，95%置信区间[CI] 3.6 至 7.3）在任务中或任务后 1 天内死亡，30 天累积死亡率为 565 例首次任务中的 35 例（6.2%，95%CI 4.5 至 8.5）（N=565）。
在丹麦配备医生的 HEMS 任务中，每 5 名儿科患者中就有 1 名需要高级院外护理。在住院患者中，近五分之一的患者需要立即接受重症监护，6.2%的患者在任务后 30 天内死亡。
