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美国直升机紧急医疗服务(HEMS)对院外心脏骤停(OHCA)的响应。

Helicopter emergency medical services (HEMS) response to out-of-hospital cardiac arrest (OHCA) in the United States.

作者信息

Shekhar Aditya C, Auten Michael, Abbott Ethan E, McCartin Michael, Blumen Ira J

机构信息

Icahn School of Medicine at Mount Sinai, New York City, NY, USA.

Section of Emergency Medicine, University of Chicago Medicine, Chicago, IL, USA.

出版信息

Resusc Plus. 2024 May 11;18:100658. doi: 10.1016/j.resplu.2024.100658. eCollection 2024 Jun.

Abstract

INTRODUCTION

Helicopter emergency medical services (HEMS) are used in the United States and globally to respond to patients with critical illness and victims of traumatic injury. Relatively limited research has examined their role in responding to out-of-hospital cardiac arrests (OHCA) in the United States. In this study, we compared OHCA treated by HEMS units with cardiac arrests treated by ground ambulances.

METHODS

We queried a large national-level database of emergency medical services (EMS) activations in the United States (NEMSIS). Inclusion criteria were OHCA activations between January 1, 2022 and December 31, 2022 treated by either HEMS or ground ambulance. Key arrest data from both groups were then compared. Interfacility transfers and cardiac arrests after EMS arrival were excluded.

RESULTS

A total of 1,233 cardiac arrests treated by HEMS and 341,096 cardiac arrests treated by ground ambulances met inclusion criteria. Comparing the two groups, cardiac arrests with HEMS response were more likely to be male (66.7% vs. 62.8%, p < 0.01), White (50.2% vs. 45.7%, p < 0.01), under 18 years old (10.9% vs. 2.7%, p < 0.001), associated with traumatic injury (19.1% vs. 5.7%, p < 0.001), witnessed (72.7% vs. 37.3%, p < 0.001), and initially-shockable (24.7% vs. 11.1%, p < 0.001).

CONCLUSION

Our comparison of cardiac arrests treated by HEMS with cardiac arrests treated by ground ambulance reveals significant differences between the two groups. Further research is needed to better characterize HEMS' ideal role in the response to OHCA as new prehospital resuscitative techniques for non-traumatic and traumatic cardiac arrest are developed.

摘要

引言

直升机紧急医疗服务(HEMS)在美国及全球范围内用于救治危重病患者和创伤伤者。在美国,相对有限的研究探讨了其在院外心脏骤停(OHCA)救治中的作用。在本研究中,我们比较了由HEMS单位救治的OHCA与由地面救护车救治的心脏骤停情况。

方法

我们查询了美国一个大型国家级紧急医疗服务(EMS)启动数据库(NEMSIS)。纳入标准为2022年1月1日至2022年12月31日期间由HEMS或地面救护车救治的OHCA启动情况。然后比较两组的关键心脏骤停数据。排除机构间转运和EMS到达后的心脏骤停情况。

结果

共有1233例由HEMS救治的心脏骤停和341,096例由地面救护车救治的心脏骤停符合纳入标准。比较两组,由HEMS响应的心脏骤停患者更可能为男性(66.7%对62.8%,p<0.01)、白人(50.2%对45.7%,p<0.01)、18岁以下(10.9%对2.7%,p<0.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48d9/11092393/68bc4d419310/gr1.jpg

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