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航空医疗救护空地一体化模式实践与探讨

Practice and discussion on air-ground integration mode of air medical service

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【作者】 张治平; 苏晞; 张勇; 江旺祥; 邹勇; 丁方勇;

【Author】 ZHANG Zhiping;SU Xi;ZHANG Yong;JIANG Wangxiang;ZOU yong;DING fangyong;Wuhan Asia General Hospital Affiliated to Wuhan University of Science and Technology;

【通讯作者】 苏晞;江旺祥;

【机构】 武汉科技大学附属武汉亚心总医院; 武汉市急救中心;

【摘要】 目的 对医疗机构主导的航空医疗救护运营模式、航空医疗救护转运案例以及飞行任务特征进行分析,旨在总结航空医疗救护经验,为建立区域性航空医疗救护体系提供实践依据。方法 以2019年7月—2022年6月武汉亚心总医院直升机转运案例为研究对象,收集患者的年龄、性别、诊断、转运主要辅助措施、转入本院的主要治疗措施以及转归等资料,对飞行区域、临时起降点、飞行距离、任务响应时间、地面接驳时间、转运时间、任务总时间等进行统计分析。结果 直升机成功转运患者123例,男性87例,女性36例。年龄以45~74岁为主。疾病按系统分类:心血管系统86例,神经系统15例,损伤16例,呼吸系统及其他6例。转运辅助措施:气管插管42例,主动脉内球囊反搏(IABP)2例,体外肺膜氧合(ECMO)3例。转入武汉亚心总医院101例,转入其他医院22例。转入武汉亚心总医院的患者中,心血管系统疾病占比高于其他系统疾病(P<0.05)。在123次飞行任务中,转诊医院内起降91次,公共场所起降32次。单程飞行距离中位数为190 km,航线批复时间中位数为30 min,起飞至抵达临时起降点时间中位数为54 min,地面接驳时间中位数为52 min,空中转运时间中位数为52 min,任务总时间中位数为185 min。转诊医院内起降的地面接驳时间短于公共场所起降的地面接驳时间(46 vs. 74 min,P<0.001)。结论 医疗机构主导的航空医疗救护运营模式在区域性航空医疗救护转运中发挥了积极的作用,促进航空医疗救护区域合作,扩大了医疗救治范围,使危重症患者得到快速转诊与有效救治;转诊医院建立直升机临时起降点有利于节省地面接驳时间,提高直升机转运效率。

【Abstract】 Objective To analyzes the operation mode of air medical service led by medical institutions, the transfer cases and the mission characteristics of air medical service, so as to summarize the experience of air medical service and provide practical basis for the establishment of regional air medical service system.Methods From July 2019 to June2022, the helicopter transfer case of Wuhan Asia general hospital were taken as the research objects, the data of patients were collected, including age, sex, diagnosis, main treatment measures of transfer, the treatment measures and prognosis of patients transferred to Wuhan Aisa general hospital. The flight area, temporary takeoff and landing points, flight distance, mission response time, ground connection time, transfer time, total mission time, etc. were statistically analyzed.Results 123 patients were successfully transferred by helicopter, 87 of them were male, 36 of them were female. The age is mainly 45-74 years old. According to the system classification, there were 86 cases of cardiovascular diseases, 15 cases of nervous system diseases, 16 cases of injury, and 6 cases of respiratory system and other diseases.Transport treatment measures included endotracheal intubation in 42 cases, intra aortic balloon counterpulsation(IABP)assisted transport in 2 cases, and extracorporeal membrane oxygenation(ECMO) assisted transport in 3 cases. One hundred and one cases were transferred to Wuhan Aisa general hospital, and 22 cases were transferred to other hospitals. Among the patients transferred to Wuhan Aisa general hospital, the proportion of cardiovascular diseases was higher than that of other diseases(P<0.05). Of the 123 flight missions, 91 took off and landed in the referral hospitals and 32 took off and landed in the public places. The median one-way flight distance was 190 km, the median route approval time was 30min, the median time from take-off to arrival at the temporary takeoff and landing point was 54min, the median ground connection time was 52 min, the median air transfer time was 52 min, the median total mission time was 185 min. The ground connection time of taking off and landing in hospitals is shorter than that of taking off and landing in public places(46vs.74 min, P<0.001).Conclusion The operation mode of air medical service led by medical institutions has played a positive role in the regional air medical transfer, promoted the regional cooperation of air medical service, expanded the scope of medical treatment, and made critical patients receive rapid referral and effective treatment. The establishment of temporary take-off and landing points for helicopters in referral hospitals is conducive to saving ground connection time and improving helicopter transfer efficiency.

【基金】 武汉市卫生健康科研基金资助(编号:WG20D13)
  • 【文献出处】 中国急救复苏与灾害医学杂志 ,China Journal of Emergency Resuscitation and Disaster Medicine , 编辑部邮箱 ,2023年09期
  • 【分类号】R459.7
  • 【下载频次】8
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