Keyword-Based Early Request for Helicopter Emergency Medical Services in Acute Aortic Dissection: A Registry-Based Study

Q3 Nursing

Air Medical Journal Pub Date : 2024-11-01 DOI:10.1016/j.amj.2024.09.006

Hiroaki Taniguchi MD, Hiroki Nagasawa MD, PhD, Tatsuro Sakai MD, Hiromichi Ohsaka MD, PhD, Kazuhiko Omori MD, PhD, Youichi Yanagawa MD, PhD

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引用次数: 0

Abstract

Objective

Acute aortic dissection (AAD) is a life-threatening condition that necessitates rapid medical intervention. In Japan, helicopter emergency medical services (HEMS) are deployed using either keyword-based early requests or standard requests from ground emergency medical services (GEMS). This study evaluates the impact of these request methods on patient outcomes.

Methods

We conducted a retrospective cohort study using data from the Japanese Society for Aeromedical Services registry from April 2015 to March 2020. A total of 342 AAD patients transported by HEMS were analyzed, excluding those with out-of-hospital cardiac arrest. Patients were categorized based on whether HEMS was requested using a keyword method or after initial GEMS contact. We compared the groups on time intervals, prehospital interventions, and outcomes including Cerebral Performance Category.

Results

The time from GEMS awareness to HEMS contact was significantly shorter in the keyword methods group compared with the control group (median 27 vs. 33 minutes, respectively; P < .001). No significant difference was observed in the time from contact to departure from the scene. Patient characteristics, vital signs at HEMS staff contact, and medical interventions provided by HEMS staff showed no statistically significant differences. Changes in vital signs from HEMS staff contact to hospital arrival included a significant decrease in the respiratory rate and systolic blood pressure. Patients in the keyword methods group had a significantly higher proportion of favorable outcomes in terms of Cerebral Performance Category compared with the control group (77.2% vs. 66.5%, P = .03). However, logistic analysis did not show significant differences (odds ratio = 1.007; 95% confidence interval, 0.987-1.016; P = .814).

Conclusion

Keyword methods for early HEMS requests may appear to reduce time to specialty care and suggest improvement of outcomes for patients with AAD.

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基于关键词的急性主动脉夹层直升机紧急医疗服务早期请求：一项基于登记的研究

目的急性主动脉夹层（AAD）是一种危及生命的疾病，需要快速的医疗干预。在日本，利用基于关键字的早期请求或地面紧急医疗服务的标准请求部署直升机紧急医疗服务。本研究评估了这些请求方法对患者结果的影响。方法采用2015年4月至2020年3月日本航空医学服务协会注册数据进行回顾性队列研究。本研究共分析了342例HEMS运送的AAD患者，不包括院外心脏骤停患者。患者分类基于是否使用关键字方法或在初始GEMS接触后要求HEMS。我们比较了两组的时间间隔、院前干预和包括脑功能类别在内的结果。结果与对照组相比，关键词方法组从知晓GEMS到接触HEMS的时间显著缩短(中位数分别为27分钟和33分钟；P & lt;措施)。从接触到离开现场的时间没有显著差异。患者特征、HEMS工作人员接触时的生命体征和HEMS工作人员提供的医疗干预没有统计学上的显著差异。从HEMS工作人员接触到医院到达，生命体征的变化包括呼吸频率和收缩压的显著下降。关键词方法组患者在脑功能分类方面的良好预后比例显著高于对照组（77.2% vs. 66.5%, P = 0.03）。然而，logistic分析未显示显著性差异(优势比= 1.007；95%置信区间为0.987 ~ 1.016；P = .814)。结论针对AAD患者早期HEMS请求的关键词方法可减少专科护理时间，改善预后。

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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来源期刊

Air Medical Journal Nursing-Emergency Nursing

CiteScore

1.20

自引率

0.00%

发文量

112

审稿时长

69 days

期刊介绍： Air Medical Journal is the official journal of the five leading air medical transport associations in the United States. AMJ is the premier provider of information for the medical transport industry, addressing the unique concerns of medical transport physicians, nurses, pilots, paramedics, emergency medical technicians, communication specialists, and program administrators. The journal contains practical how-to articles, debates on controversial industry issues, legislative updates, case studies, and peer-reviewed original research articles covering all aspects of the medical transport profession.