Burney R E, Fischer R P
Ann Emerg Med. 1986 Dec;15(12):1491-5. doi: 10.1016/s0196-0644(86)80950-7.
Emergency aeromedical transport for trauma victims varies widely, from 10% or less in some programs to more than 90% in others. There is the potential in all such programs for dramatic, lifesaving efforts as well as for costly and dangerous overuse. We propose the following preliminary guidelines for emergency aeromedical transport of trauma victims. Trauma scene flights should be dispatched only for seriously injured patients who are potentially salvageable. Trauma scene flights are not justified if the flight does not significantly reduce the interval between injury and patient arrival at an appropriate hospital (eg, from motor vehicle accident with entrapment) unless the flight delivers needed medical expertise or equipment to the scene. Critically injured patients should be returned to the closest hospital of appropriate capabilities and demonstrated expertise. Flight services should be a public service fully integrated into the metropolitan emergency medical services system. Scene flights should be dispatched within medical guidelines established by the regional emergency medical services system. Emergency aeromedical evacuation of trauma victims should assist the regionalization of trauma care to centers with special capabilities for the management of seriously injured patients. Promulgation of more detailed guidelines will depend on the accumulation of clinical experience and will be possible only if consistent efforts are made to obtain measures of injury severity, categories of injury, and long-term outcomes of management.
创伤患者的紧急航空医疗转运差异很大,在一些项目中占比10%或更低,而在另一些项目中则超过90%。所有此类项目都有可能做出巨大的、挽救生命的努力,也有可能出现代价高昂且危险的过度使用情况。我们提出以下关于创伤患者紧急航空医疗转运的初步指导原则。创伤现场飞行仅应派遣给有潜在挽救可能的重伤患者。如果飞行不能显著缩短受伤与患者抵达合适医院之间的间隔时间(例如,对于被困在机动车事故中的患者),除非飞行将所需的医疗专业知识或设备运送到现场,否则创伤现场飞行是不合理的。重伤患者应被送回具备相应能力且有专业经验证明的最近医院。飞行服务应作为一项公共服务,完全融入大都市紧急医疗服务系统。现场飞行应在区域紧急医疗服务系统制定的医疗指导原则内派遣。创伤患者的紧急航空医疗后送应有助于将创伤护理区域化到具备管理重伤患者特殊能力的中心。更详细指导原则的颁布将取决于临床经验的积累,并且只有在持续努力获取损伤严重程度、损伤类别以及管理的长期结果等衡量指标的情况下才有可能实现。