Ejection as a key word for the dispatch of a physician staffed helicopter: the Swiss experience.

Details

Serval ID
serval:BIB_7E2B0BE8D02F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ejection as a key word for the dispatch of a physician staffed helicopter: the Swiss experience.
Journal
Resuscitation
Author(s)
Schoettker P., Ravussin P., Moeschler O.
ISSN
0300-9572 (Print)
ISSN-L
0300-9572
Publication state
Published
Issued date
2001
Peer-reviewed
Oui
Volume
49
Number
2
Pages
169-173
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
We evaluated the type and severity of injuries and the possible influence of a helicopter staffed by a physician on the outcome of 71 consecutive occupants ejected from a four-wheel vehicle ejected occupants who were cared for by the Swiss Air Rescue Helicopter team from January 1994 to February 1999. The investigation and the data collection were planned prospectively. The following data were collected for each patient ejected from a four wheel vehicle: (1) demographic information; (2) type of injury; (3) vital signs on scene, in flight and at hospital; (4) hospital diagnosis; (5) injury severity score; (6) secondary transfer; (7) length of stay in hospital and on intensive care; and (8) outcome at hospital discharge. A control group included consecutive patients cared for by the same rescue team during the same period but who were not ejected out of their vehicle. Forty-four percent of the ejected patients had a GCS < or = 8, 21% were hypotensive and 22% had respiratory problems. Nine patients died at the scene. A total of 53% of the 62 ejected patients who were transported had an ISS > or = 16. The median ISS was 17. A total of 37% of the patients were intubated at the scene, needle chest decompression was performed in 5% and major analgesia was used in 27% of the cases. A total of 38% of the patients needed surgery in the first 4 h, 34% needed intensive care. No patient needed secondary transfer to the Trauma Centre if they were not brought there in the first instance. The outcome was poor in 27 cases (38%): 17 died and 10 needed transfer to specialised institutions. Non-ejected patients suffered mostly from head and neck injuries (50%) of which 9% were severe (head and neck AIS > or = 4, P < 0.05). Thoracic injuries were less frequent (35%) of which 13% were severe (thorax AIS > or = 4, P < 0,05). The median ISS was 9 for the non-ejected patients, P < 0.05. In conclusion, ejection from a four-wheel vehicle causes more severe injuries and requires a high number of advanced life support manoeuvres. Based on the mechanism of injury alone, patients ejected from four-wheel vehicles should automatically receive a response from the best available pre-hospital team. In our system, this means the dispatch of a physician staffed helicopter.
Keywords
Accidents, Traffic, Adolescent, Adult, Aged, Aged, 80 and over, Air Ambulances, Automobiles, Child, Child, Preschool, Emergency Medical Services, Female, Humans, Male, Middle Aged, Physicians, Prospective Studies, Switzerland
Pubmed
Web of science
Create date
17/01/2008 16:20
Last modification date
20/08/2019 14:39
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