Leicht M J, Dula D J, Brotman S, Anderson T E, Gessner H W, Parrish G A, Rose W D
Ann Emerg Med. 1986 Apr;15(4):450-3. doi: 10.1016/s0196-0644(86)80186-x.
One hundred twenty-six consecutive ACS Category I motor vehicle trauma patients transported by helicopter from 25 hospitals to a regional trauma center in rural Pennsylvania during a 14-month period were reviewed retrospectively. The overall mortality was 13%. Average round-trip distance was 79 miles. Interventions by the medical flight team (emergency physician/nurse) included endotracheal intubation, tube thoracostomy, and/or central venous access in 42 patients (33%) prior to lift-off. Ground time at the referring facility, from landing to lift-off, when no interventions were required of the flight team, averaged 31.2 minutes (baseline). Ground time when major therapeutic interventions were required (principally airway management), however, averaged 57.4 minutes, an 84% increase over baseline (P less than .01). A major cause of the excessive ground times was the lack of standardized diagnostic workup and stabilization of patients prior to arrival of the flight team. Recommendations for standardized emergency department preparation of trauma victims requiring aeromedical evacuation are made.
回顾性分析了在14个月期间，从宾夕法尼亚州农村地区25家医院通过直升机转运至一家区域创伤中心的126例连续ACS I类机动车创伤患者。总体死亡率为13%。平均往返距离为79英里。医疗飞行团队（急诊医生/护士）在起飞前对42例患者（33%）进行了气管插管、胸腔闭式引流和/或中心静脉置管等干预措施。在无需飞行团队干预时，从降落至起飞，转诊机构的地面停留时间平均为31.2分钟（基线）。然而，在需要进行主要治疗干预（主要是气道管理）时，地面停留时间平均为57.4分钟，比基线增加了84%（P<0.01）。地面停留时间过长的一个主要原因是在飞行团队到达之前缺乏标准化的诊断检查和患者的稳定处理。针对需要航空医疗后送的创伤受害者，提出了急诊科标准化准备的建议。
