Yanagawa Youichi, Takeuchi Ikuto, Nagasawa Hiroki, Muramatsu Ken-Ichi, Ohsaka Hiromichi, Ishikawa Kouhei
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.
Air Med J. 2023 Sep-Oct;42(5):365-368. doi: 10.1016/j.amj.2023.06.001. Epub 2023 Jun 16.
A physician-staffed helicopter emergency medical service is called a doctor helicopter (DH) in Japan. We retrospectively investigated this service using a data bank provided by the Japan DH registry system.
The following details of the dispatch activity were collected: patient age and sex, vital signs (Japan Coma Scale [JCS], systolic blood pressure, heart rate, and respiratory rate) at the scene measured by emergency medical technicians (EMTs), dispatch of the DH before the EMTs made contact with patients (key words group) or after (control group), and the survival outcome at 1 month.
During the investigation period, 28,357 patient records were analyzed (key words group, n = 13,861; control group, n = 14,496). The age, JCS, and respiratory rate were significantly smaller in the key words group than in the control group. The rates of male sex and survival in the key words group were significantly greater than those in the control group. In the multivariate analysis, dispatch of the DH after EMTs made contact with the patients (odds ratio [OR] = 0.72; 95% confidence interval [CI], 0.55-0.92), female sex (OR = 0.86; 95% CI, 0.75-0.98), older age (OR = 0.97; 95% CI, 0.96-0.97), elevated respiratory rate (OR = 0.97; 95% CI, 0.97-0.98), and high JCS (OR = 0.99; 95% CI, 0.99-0.99) were associated with a decreased 1-month survival (P > .0001).
This is the first report to describe the key words method as a potential factor influencing optimal outcomes/potential survival rates in patients evacuated by the DH using the JDRS. Our study results suggest that the firefighting central command room should consider adopting the key words method when the helicopter emergency medical service is used.
在日本,由医生配备的直升机紧急医疗服务被称为医生直升机(DH)。我们使用日本医生直升机登记系统提供的数据库对这项服务进行了回顾性调查。
收集了以下调度活动的详细信息:患者的年龄和性别、现场由急救医疗技术人员(EMT)测量的生命体征(日本昏迷量表[JCS]、收缩压、心率和呼吸频率)、EMT与患者接触之前(关键词组)或之后(对照组)调度DH的情况,以及1个月时的生存结果。
在调查期间,分析了28357份患者记录(关键词组,n = 13861;对照组,n = 14496)。关键词组的年龄、JCS和呼吸频率显著低于对照组。关键词组的男性比例和生存率显著高于对照组。在多变量分析中,EMT与患者接触后调度DH(比值比[OR] = 0.72;95%置信区间[CI],0.55 - 0.92)、女性(OR = 0.86;95% CI,0.75 - 0.98)、年龄较大(OR = 0.97;95% CI,0.96 - 0.97)、呼吸频率升高(OR = 0.97;95% CI,0.97 - 0.98)和JCS较高(OR = 0.99;95% CI,0.99 - 0.99)与1个月生存率降低相关(P >.0001)。
这是第一份将关键词方法描述为影响使用日本医生直升机登记系统(JDRS)由DH转运患者的最佳结果/潜在生存率的潜在因素的报告。我们的研究结果表明,在使用直升机紧急医疗服务时,消防中央控制室应考虑采用关键词方法。