空中医疗后送中重伤烧伤重症监护的组织和实施特点

S. A. Gumenyuk, V. I. Potapov, G. V. Sheptunov, A. Sysoev, V. Egorov, A. S. Pilyaeva
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引用次数: 0

摘要

的相关性。在紧急情况下对烧伤的重伤者进行医疗后送期间组织和提供紧急医疗护理的问题至今仍然存在。院前阶段重症监护的有效性显著影响患者的病情和治疗结果。一种相当有效和安全的方式来疏散情况危急的受害者,包括那些烧伤,是使用空中救护车。同时,航空医疗运输患者的准备和管理需要解决飞行过程中的一些问题。分析近8年来轻型直升机航空医疗后送重型烧伤患者急诊后重症监护的组织实施效果。我们分析了莫斯科市卫生局莫斯科地区灾害医学科学与实践中心(CEMP)的“莫斯科市灾害医学”自动化信息和分析系统中过去8年(2014-2021年)烧伤患者医疗后送的数据。本研究采用了历史、统计、分析等方法。结果和讨论。热伤的主要原因是火灾,在事件数量和受害者人数上排名第三,在死亡人数上排名第一。在热外伤患者的结构中,有26%的患者病情特别严重和严重,其中2%的患者需要人工肺通气和气管插管。确定了轻型救护直升机医疗后送热烧伤患者气管插管人工肺通气的适应证和特点。与其他医疗后送方法相比,经过适当治疗的烧伤患者的航空医疗运输相对安全且预后更有效。当使用在向大面积烧伤受害者提供紧急医疗护理方面缺乏经验的机组人员时,应特别注意复苏和维持体温(维持人体体温)。
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Features of the organization and implementation of intensive care in seriously injured with burns during the air medical evacuation
Relevance. The problem of organizing and providing emergency medical care during the medical evacuation of seriously injured in emergency situations who received burns remains relevant up to the present time. The effectiveness of the intensive care performed at the prehospital stage significantly affects the condition of patients and the outcome of the treatment. A fairly effective and safe way to evacuate victims in critical condition, including those with burns, is the use of air ambulance. At the same time, the preparation and management of patients subject to air medical transportation requires solving a number of problems during the flight.Intention.  To analyze the results of the organization and implementation of intensive care over the past 8 years in seriously injured people with burns after emergencies during aeromedical evacuation by a light-class helicopter.Methodology. We analyzed data from the automated information and analytical system “Disaster Medicine of the city of Moscow” of the Moscow Territorial Scientific and Practical Center of Disaster Medicine (CEMP) of the Department of Healthcare of the City of Moscow concerning medical evacuation of patients with burns over the past 8 years (2014–2021). Historical, statistical, analytical methods were used in the study.Results and Discussion. The main causes of thermal injury are fires, which rank third in the number of events and the number of victims, and first in the number of deaths. In the structure of victims with thermal trauma, 26 % were in extremely serious and serious condition, of which 2 % needed artificial lung ventilation and tracheal intubation. Indications and features of artificial lung ventilation with tracheal intubation were determined for victims with thermal burns who were subject to medical evacuation by a light-class ambulance helicopter.Conclusion. Aeromedical transportation of a burn patient with adequate therapy is relatively safe and prognostically more effective compared to other methods of medical evacuation. When using flight crews with little experience in providing emergency medical care to victims with large burns, special attention should be paid to resuscitation and maintaining euthermia (maintaining human body temperature).
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28
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