Papa G, Gulotta G, Costa P, Sansone A
Istituto di Anestesia, Rianimazione e dell'Emergenza, Università degli Studi di Palermo.
Minerva Anestesiol. 1994 Jun;60(6):347-52.
To report our experience concerning the first aid effected by helicopter both on scene (primary rescue) and interhospital transport of already treated patients requiring a highest level of diagnosis and treatment (secondary rescue), and the peculiar aspect appeared from the analysis of the obtained results, that is the predominance of the secondary rescue on the primary one.
Retrospective evaluation of the interventions effected from August 1990 to February 1993.
Critical care units of a University teaching Hospital.
2669 interventions were effected: 2082 were secondary rescues (78%) and 587 primary rescue (22%). The patients actually transported by helicopter were 2419 (M = 1702; F = 717). The leading cause of non effected interventions was the deficiency of illuminated helicopter landing area; for the primary rescue, the main cause was the distance from the scene and the transport with land vehicles. The most frequent admission were for intensive care unit, neurosurgery, cardiac-surgery and neonatology, in only three towns. Indeed, the failing of Specialized Units involves the use of helicopter in interhospital transport for long periods, and this can remove time from primary rescue.
As mentioned above, the peculiar aspect of our experience is the predominance of the secondary rescue on the primary one. It can be attributed particularly to the geographic and orographical characteristics of our region, together with the organization deficiencies in the field of emergency medical services.
报告我们在直升机现场急救(初级救援)以及对已接受治疗但需要最高水平诊断和治疗的患者进行院际转运(二级救援)方面的经验,以及从所获结果分析中呈现出的特殊情况,即二级救援在数量上占主导地位。
对1990年8月至1993年2月期间实施的干预措施进行回顾性评估。
一所大学教学医院的重症监护病房。
共实施了2669次干预:2082次为二级救援(78%),587次为初级救援(22%)。实际通过直升机转运的患者有2419名(男性 = 1702名;女性 = 717名)。未实施干预的主要原因是直升机降落区域照明不足;对于初级救援,主要原因是距离现场较远以及使用陆地车辆进行转运。最常见的收治科室是重症监护病房、神经外科、心脏外科和新生儿科,且仅集中在三个城镇。实际上,专科医院的不足导致长期使用直升机进行院际转运,这可能减少了初级救援的时间。
如上所述,我们经验中的特殊情况是二级救援在数量上占主导地位。这尤其可归因于我们所在地区的地理和地形特征,以及紧急医疗服务领域的组织缺陷。