Articles: emergency-medical-services.
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Southern medical journal · Nov 1992
Effect of aeromedical aircraft on care of trauma patients: evaluation using the Revised Trauma Score.
Rotor wing aircraft used in transport of the trauma victim have not been subject to objective means of evaluating their contribution to patient care. A retrospective evaluation of a Bell 206 L-1 and an Aerospatiale 365 N-1 using the Revised Trauma Score Triage (RTS) as an indicator of status in 98 patients transported from the scene of injury was conducted. Ground (GT), flight (FT), and total mission (TMT) times, as well as initial RTS, final RTS, and the difference between them (DRTS) were determined for all patients. ⋯ GT, FT, and TMT were significantly lower in patients transported by the 365 N-1. In more severely injured patients (RTS < or = 10), DRTS and final RTS were significantly higher in the 365 N-1; FT was significantly less. The contributions of various aeromedical aircraft to the care of the trauma victim may be assessed using objective indices of patient status.
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Swiss Air Rescue (REGA) teams execute more than 3000 aeromedical missions annually, of which some require the use of a winch. To evaluate the need for early medical intervention at sites where landing is impossible, we analyzed retrospectively 100 consecutive operations (10.8% of all primary missions, 110 patients) accomplished by the REGA base at Lausanne with an emergency physician of the Centre Hospitalier Universitaire Vaudois (CHUV) on board. In such difficult rescue conditions, time to call, response times, and scene times were particularly long (mean delay to admission: 114 minutes). ⋯ Seventeen required major intervention at the site or during rescue. We conclude that in our European pre-alpine region 22% of patients rescued by winch are severely injured. Since rescue actions are particularly long and difficult, the performance of advanced procedures at the scene and during transportation is of great value.
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Swiss medical weekly · Oct 1992
[The effect of first aid and care times on the clinical course and treatment results in multiple trauma. Initial interim results of an interdisciplinary trauma registry in the St. Gallen district hospital].
To date little is known about the influence of variable rescue (i.e. transportation/preclinical care) and clinical care times on the clinical progress and outcome of patients suffering injuries ranging from average to severe. Having examined this question within the framework of an ongoing study of trauma, we present the first provisional results and compare them with existing documentation. ⋯ The database for the assessment of standard times is still inadequate. For a reliable analysis, a total number of at least 500 patients is necessary (beta error acceptable). Our own data and the meagre results of other studies support the supposition that it is not the absolute time-lapse which has prognostic significance but the qualified medical assistance provided within a critical, individual, but extremely variable time-span. The increased employment of highly qualified emergency staff and a more efficient "triage", in the sense of a clearly directed trauma regionalization, could thus lead to optimization of trauma care.