Zheng Gaigai, Yang Qiaofang, Yu Man, Ma Lingyan, Wu Na, Tian Huan, Yin Yue
Department of Nursing, the Heart Center of Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Disease Hospital, Huazhong Fuwai Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China.
Department of Cardiovascular Care Unit, the Heart Center of Henan Provincial People's Hospital, Fuwai Central China Cardiovascular Disease Hospital, Huazhong Fuwai Hospital of Zhengzhou University, Zhengzhou 450000, Henan, China.
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2023 Feb;35(2):201-205. doi: 10.3760/cma.j.cn121430-20211112-01707.
To summarize the management experience of helicopter medical transport in patients with critical heart disease, so as to provide reference for transport of patients with critical heart disease under the background of major natural disasters.
The clinical and transport data of 36 critically ill cardiac patients in Fuwai Central China Cardiovascular Hospital from 16:30 on July 21 to 19:30 on July 22, 2021 due to historically rare heavy rainstorms were collected. All 36 critically ill cardiac patients were transported by helicopter. The safe transportation was implemented under the measures of quickly forming a transport leadership and coordination group, clarifying responsibilities and division of labor, doing a good job in the pretreatment of the patient's condition, pipeline assessment and mechanical circulation support (MCS) equipment, simulating and practicing the transfer process, improving the safety of the transfer implementation process, and effectively handing over with the target hospital. The gender, age, disease type, MCS, transport and outcome of patients were collected.
Thirty-six patients with cardiac critical illness were from adult extracardiac intensive care unit (ICU), adult cardiac care unit (CCU), children's CCU, comprehensive ICU and department of neurology. There were 24 males and 12 females; age (50.93±20.86) years old. There were 12 patients using respirator, 7 patients needing MCS, 2 of whom needed both extracorporeal membrane oxygenation (ECMO) and intra-aortic balloon pump (IABP), and 7 patients with post-cardiac surgery. The total distance of transportation of 36 patients was 1 638.4 km, the transit time was 10.5 hours, one way flight time of helicopter was about 8 minutes, and the average transport time per patient was about 17.5 minutes. The vital signs of 36 patients during transport were basically stable, without complications, and all of them reached the target hospital safely.
Under the seamless connection of the rapid establishment of the transfer leadership coordination group, assessment of the patient's condition and pretreatment, the simulation of the transfer process, and the effective handover with the receiving hospital, the use of helicopter for medical transport for critically ill heart patients is feasible and safe, which can buy valuable time for saving patients' lives and further treatment.
总结直升机医疗转运危重心血管疾病患者的管理经验，为重大自然灾害背景下危重心血管疾病患者的转运提供参考。
收集2021年7月21日16:30至7月22日19:30因历史罕见暴雨灾害，在阜外华中心血管病医院接受直升机医疗转运的36例危重心血管疾病患者的临床及转运资料。36例危重心血管疾病患者均通过直升机进行转运。在迅速组建转运领导协调小组、明确职责分工、做好患者病情预处理、管路评估及机械循环支持（MCS）设备、模拟演练转运过程、提高转运实施过程安全性、与目标医院有效交接等措施保障下实施安全转运。收集患者的性别、年龄、疾病类型、MCS情况、转运情况及转归。
36例心血管危重症患者分别来自成人心脏外科重症监护病房（ICU）、成人心脏监护病房（CCU）、儿童CCU、综合ICU及神经内科。男性24例，女性12例；年龄（50.93±20.86）岁。使用呼吸机辅助通气12例，需要MCS支持7例，其中2例同时需要体外膜肺氧合（ECMO）及主动脉内球囊反搏（IABP）支持，心脏术后患者7例。36例患者总转运距离1638.4 km，转运时间10.5小时，直升机单程飞行时间约8分钟，平均每例患者转运时间约17.5分钟。36例患者转运途中生命体征基本平稳，无并发症发生，均安全抵达目标医院。
在快速建立转运领导协调小组、病情评估及预处理、转运过程模拟演练、与接收医院有效交接的无缝衔接下，利用直升机对危重心血管疾病患者进行医疗转运是可行且安全的，可为挽救患者生命及后续治疗争取宝贵时间。
