Helicopter emergency medical rescue for the traumatized: experience in the metropolitan region of Campinas, Brazil

OBJECTIVE: To analyze the profile of patients served by the air medical rescue system in the Metropolitan Region of Campinas, evaluating: triage and mobilization criteria; response time; on-site care and transport time; invasive procedures performed in the Pre-Hospital Care (PHC); severity of patients; morbidity and mortality.METHODS: We conducted a prospective, descriptive study in which we analyzed medical records of patients rescued between July 2010 and December 2012. During this period, 242 victims were taken to the HC-Unicamp. Of the 242 patients, 22 were excluded from the study.RESULTS: of the 220 cases evaluated, 173 (78.6%) were male, with a mean age of 32 years. Blunt trauma was the most prevalent (207 cases - 94.1%), motorcycle accidents being the most common mechanisms of injury (66 cases - 30%), followed by motor vehicle collisions (51 cases - 23.2%). The average response time was 10 ± 4 minutes and the averaged total pre-hospital time was 42 ± 11 minutes. The mean values of the trauma indices were: RTS = 6.2 ± 2.2; ISS = 19.2 ± 12.6; and TRISS = 0.78 ± 0.3. Tracheal intubation in the pre-hospital environment was performed in 77 cases (35%); 43 patients (19.5%) had RTS of 7.84 and ISSd"9, being classified as over-triaged. Of all patients admitted, the mortality was 15.9% (35 cases).CONCLUSION: studies of air medical rescue in Brazil are required due to the investments made in the pre-hospital care in a country without an organized trauma system. The high rate of over-triage found highlights the need to improve the triage and mobilization criteria.

研究目的：分析坎皮纳斯都会区空中医疗救援系统服务患者的特征，评估以下内容：分诊与出动标准、响应时长、现场救治与转运时长、院前急救（Pre-Hospital Care, PHC）中实施的侵入性操作、患者病情严重程度、发病率与死亡率。
研究方法：本研究为前瞻性描述性研究，分析2010年7月至2012年12月期间获救患者的医疗记录。此阶段共有242名患者被转运至HC-Unicamp（坎皮纳斯大学附属医院），其中22例被排除出本研究。
研究结果：纳入评估的220例病例中，173例（78.6%）为男性，平均年龄32岁。钝性创伤最为常见（207例，占比94.1%），其中以摩托车交通事故为最主要致伤机制（66例，占比30.0%），其次为机动车碰撞事故（51例，占比23.2%）。平均响应时长为10±4分钟，平均院前总时长为42±11分钟。创伤相关指数的平均值分别为：创伤评分（RTS）6.2±2.2、损伤严重度评分（ISS）19.2±12.6、创伤严重度评分（TRISS）0.78±0.3。院前环境下气管插管操作共实施77例（占比35.0%）；43例患者（占比19.5%）的RTS为7.84且ISS≥9，被判定为过度分诊。所有入院患者中，死亡率为15.9%（共35例）。
研究结论：巴西尚未建立完善的创伤救治体系，鉴于该国在院前急救领域的投入，亟需开展空中医疗救援相关研究。本研究发现的高过度分诊率，凸显了优化分诊与出动标准的必要性。