Characteristics and critical care interventions in drowning patients treated by the Danish Air Ambulance from 2016 to 2021: a nationwide registry-based study with 30-day follow-up

Niklas Breindahl, Signe A. Wolthers, Thea P. Møller, Stig N. F. Blomberg, Jacob Steinmetz, Helle C. Christensen
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Abstract

Improving oxygenation and ventilation in drowning patients early in the field is critical and may be lifesaving. The critical care interventions performed by physicians in drowning management are poorly described. The aim was to describe patient characteristics and critical care interventions with 30-day mortality as the primary outcome in drowning patients treated by the Danish Air Ambulance. This retrospective cohort study with 30-day follow-up identified drowning patients treated by the Danish Air Ambulance from January 1, 2016, through December 31, 2021. Drowning patients were identified using a text-search algorithm (Danish Drowning Formula) followed by manual review and validation. Operational and medical data were extracted from the Danish Air Ambulance database. Descriptive analyses were performed comparing non-fatal and fatal drowning incidents with 30-day mortality as the primary outcome. Of 16,841 dispatches resulting in a patient encounter in the six years, the Danish Drowning Formula identified 138 potential drowning patients. After manual validation, 98 drowning patients were included in the analyses, and 82 completed 30-day follow-up. The prehospital and 30-day mortality rates were 33% and 67%, respectively. The National Advisory Committee for Aeronautics severity scores from 4 to 7, indicating a critical emergency, were observed in 90% of the total population. They were significantly higher in the fatal versus non-fatal group (p < 0.01). At least one critical care intervention was performed in 68% of all drowning patients, with endotracheal intubation (60%), use of an automated chest compression device (39%), and intraosseous cannulation (38%) as the most frequently performed interventions. More interventions were generally performed in the fatal group (p = 0.01), including intraosseous cannulation and automated chest compressions. The Danish Air Ambulance rarely treated drowning patients, but those treated were severely ill, with a 30-day mortality rate of 67% and frequently required critical care interventions. The most frequent interventions were endotracheal intubation, automated chest compressions, and intraosseous cannulation.
2016年至2021年丹麦空中救护队救治的溺水患者的特征和危重症护理干预:一项基于全国登记册的30天随访研究
在现场早期改善溺水患者的氧合和通气至关重要,可能会挽救生命。医生在溺水救治过程中采取的重症监护干预措施却鲜有描述。该研究旨在描述丹麦空中救护中心救治的溺水患者的特征和重症监护干预措施,并以 30 天死亡率为主要结果。这项为期 30 天的回顾性队列研究确定了从 2016 年 1 月 1 日至 2021 年 12 月 31 日期间接受丹麦空中救护治疗的溺水患者。采用文本搜索算法(丹麦溺水公式)识别溺水患者,然后进行人工审核和验证。从丹麦空中救护数据库中提取业务和医疗数据。以 30 天死亡率为主要结果,对非致命和致命溺水事件进行了描述性分析。在这六年中,丹麦溺水公式识别了 16,841 次派遣中的 138 名潜在溺水患者。经过人工验证,98 名溺水患者被纳入分析,其中 82 人完成了 30 天的随访。院前死亡率和 30 天死亡率分别为 33% 和 67%。国家航空咨询委员会的严重程度评分从 4 到 7 分不等,表明情况危急,占总人数的 90%。死亡组和非死亡组的评分明显更高(P < 0.01)。在所有溺水患者中,68%的患者至少进行了一次危重症护理干预,其中最常进行的干预包括气管插管(60%)、使用自动胸外按压装置(39%)和骨内插管(38%)。死亡组一般采取更多干预措施(p = 0.01),包括骨内插管和自动胸外按压。丹麦空中救护很少救治溺水病人,但救治的病人病情严重,30 天死亡率高达 67%,而且经常需要重症监护干预。最常见的干预措施是气管插管、自动胸外按压和骨内插管。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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