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需要医疗后送的海上患者的流行病学:文献综述

The Epidemiology of Maritime Patients Requiring Medical Evacuation: A Literature Review.

作者信息

Dillard Jonathan S, Maynard William, Kashyap Rahul

机构信息

Search and Rescue Coordinator, U.S. Coast Guard PACAREA/D11 Command Center, Alameda, USA.

Internal Medicine, TriStar Centennial Medical Center, HCA Healthcare, Nashville, USA.

出版信息

Cureus. 2023 Nov 28;15(11):e49606. doi: 10.7759/cureus.49606. eCollection 2023 Nov.

Abstract

This literature review aims to provide an analysis of the current trends in at-sea medical evacuations (medevacs), with the objective of providing insights to decision-makers to improve patient outcomes. Sixteen sources spanning diverse research methodologies were employed for data collection. The findings point to medical disease processes outweighing trauma and psychiatric conditions as the primary justifications for medical evacuations in the international maritime community. In particular, suspected cardiovascular pathologies emerge as the most prevalent grounds for recommended evacuations, underscoring the impact of their diagnosis and treatment in maritime healthcare scenarios. Enhancing the capabilities of on-site maritime healthcare providers to obtain cardiovascular diagnostic data to facilitate shoreside interpretation is proposed to mitigate the speculations inherent to long-distance medevac decisions. Furthermore, existing research indicates that sustaining a proactive approach focusing on pre-voyage health screenings for seafarers and passenger vessel patrons holds promise in minimizing the risk of emergency evacuations resulting from the exacerbation of chronic medical conditions. This review reveals that while a limited portion of the cruise ship industry possesses established tactical medevac data on crucial aspects of patient care (such as transportation delay, pre- and mid-transport level of care, and ultimate patient outcomes), there exists a dearth of equivalent informatio-n for comparable maritime communities. This knowledge gap necessitates further exploration and research to understand and address diverse seafaring populations' unique challenges. In conclusion, this literature review holistically examines the landscape of at-sea medical evacuation statistics. By assimilating the collective knowledge gleaned from internationally sourced data, this study underscores the urgent need for continued research, comprehensive data collection, and strategic interventions to optimize patient care, enhance tactical decision-making, and ultimately shape a more resilient and responsive healthcare network for maritime communities worldwide.

摘要

本文献综述旨在分析当前海上医疗后送(medevacs)的趋势,目的是为决策者提供见解以改善患者治疗效果。采用了涵盖不同研究方法的16个来源进行数据收集。研究结果表明,在国际海事界,医疗疾病过程作为医疗后送的主要理由超过了创伤和精神疾病状况。特别是,疑似心血管疾病成为建议后送的最普遍原因,突显了其诊断和治疗在海上医疗场景中的影响。建议提高现场海上医疗服务提供者获取心血管诊断数据以促进岸上解读的能力,以减少远程医疗后送决策中固有的猜测。此外,现有研究表明,对海员和客船乘客采取积极主动的方法,专注于航行前健康筛查,有望将慢性疾病恶化导致紧急后送的风险降至最低。本综述显示,虽然邮轮行业的一小部分在患者护理的关键方面(如运输延误、运输前和运输中的护理水平以及最终患者治疗效果)拥有既定的战术医疗后送数据,但类似的海事社区却缺乏同等信息。这一知识差距需要进一步探索和研究,以了解和应对不同航海人群的独特挑战。总之,本文献综述全面审视了海上医疗后送统计数据的全貌。通过吸收从国际来源数据中收集的集体知识,本研究强调了持续研究、全面数据收集和战略干预的迫切需求,以优化患者护理、加强战术决策,并最终为全球海事社区塑造一个更具弹性和响应能力的医疗保健网络。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/158b/10755129/10b2e6bbec64/cureus-0015-00000049606-i01.jpg

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