Articles: emergency-medical-services.
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Schweiz. Rundsch. Med. Prax. · Mar 1992
[Development of the helicopter-rescue concept in the Basel region].
1927 medical helicopter transports were performed in Basle between 1986 and 1989. Of the total flights, 173 transports without patients and 186 incubator transports were excluded from the study. Treatment and transportation were provided for 1085 victims of trauma (70.2%) and 461 medical-surgical patients (29.8%), mostly with life-threatening conditions. 589 trauma patients were treated at the scene of accident and later transported by helicopter to a nearby medical center (54.3%). ⋯ Transport generally occurs only after stabilization of vital functions. These factors contribute to the low mortality before return flights (3%) as well as during transport (0.3%). We conclude that early aggressive in-field intensive therapy can help to decrease both morbidity and mortality in emergency-care patients.
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A 5-year retrospective review of airway management by flight nurses was conducted to evaluate airway care and to determine the frequency of surgical cricothyrotomy. Intubation was attempted in 51% of patients, with a success rate of 80%. ⋯ Overall, 87% of patients were successfully intubated and surgical cricothyrotomy was required in only one patient. A greater success rate was achieved when intubations were performed before takeoff than during flight.
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The effect of trauma may be graded by the extent of anatomical injury caused or functional derangement created. The anatomical scoring is useful in determining the trauma load in a hospital and for comparisons between hospitals. It correlates well with the need for resources. ⋯ These two may be combined into the TRISS method for assessing probability of survival. Under conditions of war, patients are divided into groups which either have to be operated, which can wait or which have to wait. War wounds are graded according to the extent of soft tissue damage, involvement of deeper structures and whether the wound contains foreign bodies.