Division of Prehospital Services, Air Ambulance Department, Oslo University Hospital, Oslo, Norway.
Department of Anaesthesiology, Intensive Care Medicine and Surgical Services, Førde Central Hospital, Førde, Norway.
Scand J Trauma Resusc Emerg Med. 2024 Nov 21;32(1):118. doi: 10.1186/s13049-024-01289-9.
Timely medical management and evacuation of critically ill or injured patients from austere environments or maritime vessels is often achieved by helicopter hoist operations. When indicated, intubation is performed onsite to restore and sustain patient physiology and to facilitate safe transport. We aimed to describe the characteristics of helicopter hoist operations (HHOs) with intubated patients in a physician staffed SAR helicopter service and to identify learning points for future missions.
The Norwegian national SAR database and local medical journal systems on six SAR helicopter bases were searched for data on hoisted intubated patients from January 2011 to April 2024.
From a total of 18,710 missions, we registered 2,423 helicopter hoist operations with patients as human external cargo. In 54 hoist operations (2%) the patients were intubated prior to hoisting. We observed an increasing number of both HHOs in general and HHOs with intubated patients over time. The intubated HHO patients were in an overall critical state, with a median NACA score of 6 and a median GCS of 3 before intubation. Trauma was the main cause of intubation (n = 32). Twenty-five patients presented with cardiac arrest, 13 of whom were hoisted with an ongoing mechanical chest compression device. During the hoist operation, 34 patients were ventilated manually, and 20 patients were connected to an automatic ventilator. Monitoring of vital parameters during hoisting varied from none to fully monitored patients including invasive arterial blood pressure. Twenty-eight patients, seven of whom presented with initial cardiac arrest, survived to hospital discharge.
HHOs with intubated patients are rare but increasingly occurring events in our service. Owing to the infrequency, complexity and risk factors involved, these operations should be governed by specific operating procedures and trained regularly to be performed safely. HHOs with intubated patients represents a favourable alternative in situations where terrestrial transport is associated with significant time delay or additional risk to the patient or the rescuers.
在严峻的环境或海船上，对重症或受伤患者进行及时的医疗管理和转移通常通过直升机吊运操作来实现。在有需要的情况下，会在现场进行插管，以恢复和维持患者的生理机能，并为安全转运提供便利。本研究旨在描述配备医生的搜救直升机服务中，进行有创插管患者的直升机吊运操作（HHO）的特点，并为未来的任务确定学习要点。
在 2011 年 1 月至 2024 年 4 月期间，检索挪威国家搜救数据库和六个搜救直升机基地的本地医学期刊系统，以获取有关直升机吊运有创插管患者的数据。
在总共 18710 次任务中，我们记录了 2423 次患者作为人体外部货物的直升机吊运操作。在 54 次吊运操作（2%）中，患者在吊运前进行了插管。我们观察到，总体而言，直升机吊运操作和有创插管患者的数量都在不断增加。进行有创插管的 HHO 患者总体处于危急状态，在插管前，NACA 评分为 6，GCS 评分为 3。创伤是插管的主要原因（n=32）。25 例患者出现心脏骤停，其中 13 例使用正在进行的机械胸部按压设备进行吊运。在吊运过程中，34 例患者手动通气，20 例患者连接自动呼吸机。吊运过程中生命体征的监测从无到对包括有创动脉血压在内的所有患者进行全面监测不等。28 例患者存活至出院，其中 7 例在最初出现心脏骤停时存活。
有创插管患者的直升机吊运操作虽然罕见，但在我们的服务中越来越常见。由于频率低、复杂性和涉及的风险因素，这些操作应由特定的操作程序管理，并定期进行培训，以确保安全进行。在陆地转运会给患者或救援人员带来显著时间延迟或额外风险的情况下，有创插管患者的直升机吊运操作是一种有利的替代方法。
