Effectiveness of a "doctor-helicopter" system in Japan.

Autor:	Matsumoto H; Shock and Trauma Center, Inba-Hitec Medical Center, Nippon Medical School, Inba County, Chiba, Japan. hmatsu@nms.ac.jp, Mashiko K, Hara Y, Sakamoto Y, Kutsukata N, Takei K, Tomita Y, Ueno Y, Yamamoto Y
Jazyk:	angličtina
Zdroj:	The Israel Medical Association journal : IMAJ [Isr Med Assoc J] 2006 Jan; Vol. 8 (1), pp. 8-11.
Abstrakt:	Background: In Japan, helicopters have rarely been used for emergency medical services. The use of helicopters not only ensures rapid evacuation but may also serve to provide emergency management to patients with life-threatening injuries in the prehospital setting. Objectives: To evaluate a Japanese helicopter-based emergency medical system including an onboard physician, particularly in terms of probability of survival. Methods: We conducted a retrospective review of trauma victims, and calculated two estimates of PS--at the scene and on arrival at the emergency department--based on patient age, Injury Severity Score, and Revised Trauma Score. Results: We identified trauma victims who had an ISS above 15 and were transported from the scene by helicopter. Excluding cardiopulmonary arrest at the scene, 151 cases were studied. Thirty-two patients had hemodynamic instability with systolic blood pressures below 90 mmHg, caused by hemorrhagic shock (29 cases) or obstructive shock (3 cases). Their PS values were 0.56 +/- 0.38 in the prehospital setting and 0.65 +/- 0.38 on arrival at the ED, representing a significant difference (P = 0.0003). Twenty-four of these patients survived, reflecting successful resuscitation during prehospital and ED management. Conclusions: A doctor-helicopter system was shown to improve probability of survival for life-threatening trauma in the Japanese emergency medical system.
Databáze:	MEDLINE
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