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Efficacy of physician manned helicopter ambulance service in trauma survival
THUR 1130
Efficacy of Physician Manned Helicopter Ambulance Service in Trauma Survival.
Carl Bergren, Bobby Lewis, Robert P. Carraway, Raleigh Kent, III; Carraway Methodist Medical Center, 1600 N. 26th Street, Birmingham, Alabama 35234. Between January 1 and December 31, 1988, 211 trauma scene flights by a physician manned helicopter ambulance service were evaluated. 128 cases involved automobile accidents (101 survivors, 27 deaths), 37 gunshot wounds (18 survivors, 19 deaths), 5 stabbings, 8 autopedestrian accidents, 7 industrial accidents, 6 motorcycle accidents, 20 falls and miscellaneous causes (18 survivors, 2 deaths) . Overall mortality was 22.6%. There were no significant differences in the age, sex, round trip mileage or flight times between survivors and non-survivors. The overall trauma score was 12.3 (14.1 :st.rvivors and 6.2 non-survivors). An improved survival rate was noted among patients with a trauma score less than 12 when compared to published predicted survival rates. Head and neck injuries were most common. Combined head and chest injuries were noted in 35% of survivors and 85% of non-survivors involved in motor vehicle accidents. Airway management was the most common type of procedure performed by physicians. Nurses performed intravenous access procedures most commonly. This study demonstrates an improved survival rate in patients with a trauma score of less than 12 using a physician manned helicopter ambulance service when compared to predicted survival rates with similar trauma scores. This improved survival rate is related to aggressive airway and fluid management provided by a physician-nurse crew in transport to a regional trauma center.
The Journal of Air Medical Transport • October 1989
POSTER 1
LIGHTED STYLET Richard Cook, Kichael Dubin, Donald Junst, Lloyd Svisher LIll LION Aeroledical Service Kilton S. Hershey Medical Center P.O . Box 850, Hershey, PA 17033 INTRODUCTION : Indotracheal tUbes lay becole dislodged during air medical transport. We report here the use of the lighted stylet (LSI, preViously discussed by others in ground pre-hospital care, as a qUick, easily used aid to intubation and correct tube placeDent verification in air ledical transport. KITHODS: The literature and product information on the lighted stylet, (Concept Inc., nasal and oral versions) were reviewed by the ledical flight teal (HYTI. In vivo LS use was delonstrated to and performed by the M1T lelbers in order to learn the possible patterns of transillulination in the soft tissues of the neck. DISCUSSION : In the initial phase of the usage of this airway adjunct, the nasal LS was utilized to verify endotracheal tube place.ent in 5 patients. In I patients, it corroborated successful placement. In one patient, it vas not possible to pass the LS through the tube owing to the external compression of the IUlen of the tube by tube-securing apparatus of the referring hospital. In several instances, it vas noted by KYT that this nev lethod vas useful for theD and increased significantly their confidence in correct tube placelent. This adjunct has been rapidly absorbed frol the experilental into the clinical usage arDaDentarluD of the HfT. Of note, it vas found that in situations in vhich the bright lidline glow was not readily noted daring what appeared to be a successful intubation, compression of the soft tissue overlying the tip of the LS resulted in the traditional picture of what should appear in correct placement, i.e. , a 'bright lid-line glow'. CONCLUSION: The lighted stylet is useful for verification of correct endotracheal tube placelent in the helicopter environDent . COlpression of the soft tissue of the neck lay aid in noting the classically described 'bright lid-line glov' .
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Efficacy of Physician Manned Helicopter Ambulance Service in Trauma Survival.
Carl Bergren, Bobby Lewis, Robert P. Carraway, Raleigh Kent, III; Carraway Methodist Medical Center, 1600 N. 26th Street, Birmingham, Alabama 35234. Between January 1 and December 31, 1988, 211 trauma scene flights by a physician manned helicopter ambulance service were evaluated. 128 cases involved automobile accidents (101 survivors, 27 deaths), 37 gunshot wounds (18 survivors, 19 deaths), 5 stabbings, 8 autopedestrian accidents, 7 industrial accidents, 6 motorcycle accidents, 20 falls and miscellaneous causes (18 survivors, 2 deaths) . Overall mortality was 22.6%. There were no significant differences in the age, sex, round trip mileage or flight times between survivors and non-survivors. The overall trauma score was 12.3 (14.1 :st.rvivors and 6.2 non-survivors). An improved survival rate was noted among patients with a trauma score less than 12 when compared to published predicted survival rates. Head and neck injuries were most common. Combined head and chest injuries were noted in 35% of survivors and 85% of non-survivors involved in motor vehicle accidents. Airway management was the most common type of procedure performed by physicians. Nurses performed intravenous access procedures most commonly. This study demonstrates an improved survival rate in patients with a trauma score of less than 12 using a physician manned helicopter ambulance service when compared to predicted survival rates with similar trauma scores. This improved survival rate is related to aggressive airway and fluid management provided by a physician-nurse crew in transport to a regional trauma center.
The Journal of Air Medical Transport • October 1989
POSTER 1
LIGHTED STYLET Richard Cook, Kichael Dubin, Donald Junst, Lloyd Svisher LIll LION Aeroledical Service Kilton S. Hershey Medical Center P.O . Box 850, Hershey, PA 17033 INTRODUCTION : Indotracheal tUbes lay becole dislodged during air medical transport. We report here the use of the lighted stylet (LSI, preViously discussed by others in ground pre-hospital care, as a qUick, easily used aid to intubation and correct tube placeDent verification in air ledical transport. KITHODS: The literature and product information on the lighted stylet, (Concept Inc., nasal and oral versions) were reviewed by the ledical flight teal (HYTI. In vivo LS use was delonstrated to and performed by the M1T lelbers in order to learn the possible patterns of transillulination in the soft tissues of the neck. DISCUSSION : In the initial phase of the usage of this airway adjunct, the nasal LS was utilized to verify endotracheal tube place.ent in 5 patients. In I patients, it corroborated successful placement. In one patient, it vas not possible to pass the LS through the tube owing to the external compression of the IUlen of the tube by tube-securing apparatus of the referring hospital. In several instances, it vas noted by KYT that this nev lethod vas useful for theD and increased significantly their confidence in correct tube placelent. This adjunct has been rapidly absorbed frol the experilental into the clinical usage arDaDentarluD of the HfT. Of note, it vas found that in situations in vhich the bright lidline glow was not readily noted daring what appeared to be a successful intubation, compression of the soft tissue overlying the tip of the LS resulted in the traditional picture of what should appear in correct placement, i.e. , a 'bright lid-line glow'. CONCLUSION: The lighted stylet is useful for verification of correct endotracheal tube placelent in the helicopter environDent . COlpression of the soft tissue of the neck lay aid in noting the classically described 'bright lid-line glov' .
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