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O-29 The primary course of patients following advanced life support (ALS) in Copenhagen
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O-28 PREHDSPITAL ADVANCED WE SUPF’ORT DEMANDS IN TM CITV OF COPENHAGEN.
O-30 (ALSI
M. Bradgaard Serensen, S. Hegskilde, 6. Oberg, H. Reich, M.E. Crawford. The Mobile Intensive Care Unit. The Municipal Hospital of Copenhagen, Copenhagen, Denmark.
EMERGENCY ROOM THORACOTOMY FOR PENETRATING TRAIIMA: ADMISSION CHARACTERISTTrS THAT PREDICT SIlKVIVA! 'ID Dl SCUARGE. R.R.Ballard ND., C.A.Kynon HBBS., Ruclrman MD. Department of Surgery, Hospital, Philadelphia, LISA.
M.M.Badellin,, MD.. Temple univereity
R.!.
The Copenhagen Mobile Intensive Care Unit (MICU) is manned by experienced anaesthesiologists and specially trained ambulance drivers from the Copenhagen Fire Department. It has been active since 1985 serving a population of 48O.OOO Inhabitants. There is one 24-hour unit and a supplementary unit operating averagely 10 h I day. When necessary the alarm centre activates the MICIJ which participates in a rendez-vous system with the local ambulances in the city.ln 1994 the MlCU was celled 5.958 times with an equal distribution of 444-571 calls per month. The weekdays were also equally busy f13.6-15.7% of the weekly calls). 60% of the calls took place during the daytime (06.OO-20.001 vs. 40% at night. In 75.2% of the calls the MICU made contact with one or more patients, the median response time being 4.8 minutes. In 8.8% of the cases the treatment could be characterized as primary life saving, in 48.6% the condition was improved, in 38.1% unchanged, wheras 4,5% of the patients deteriorated or died. 58.5% were men and 41.5% women. 5.5% were children < 15 yr. 48.2% 15-65 years old, and 42.7% > 65 years. The alarm centre was able to activate the MICU in 69% of the cases, where it was considered necessary. We conclude that there is a definite need for prehospital ALS in the city of Copenhagen. The MICU is effective with a good cost-beclefit ratio.
hospital, affect survival to hospital discharge in patients requiring emergency room thoracotomv fERT1. Method: Ketroepectivc revi& of all admissions requiciog ERT for penecracing trauma in an urban, level 1 trauma center over a six year period. Data were analyzed using the Fisher exact test. Resulte: 242 patients (age 7-78 years) raqoirrd ERT. Overall survival to discharge was 9.9% (24 cases). 12/2Db (5.B%) gunshot wounds survived to discharge compared to 12/ 36 (33%) stab wounds (p
O-29
o-31
THE PRIMARY COURSE OF PATIENTS FOLLOWING ADVANCED LIFE SUPPORT (AL% IN COPENHAGEN. B.Obera,S.Hegskilde,M.Crawford,l.Meller, MBredgaard Sorensen. The Mobile Intensive Care Unit, Municipal Hospital of Copenhagen, Copenhagen, Denmark. The Copenhagen Mobile Intensive Care Unit (MICU) is based in the centre of Copenhagen and participates in a rendez-vous system with 8-12 local ambulances serving the city. Usually the ambulance arrives at the scene of the accident or acute illness first and initiates basic life support (BLSI; when the MICU arrives a few minutes later advanced medical treatment can be given. In 1994 the MICU was called to 4.521 patients. Of these patients 2570 (56.8%) ware transported to the nearest relevant hospital. 1257 patients (27.8%) received definitive treatment by the ambulance doctor, so that hospitalisation became unneccessary. 694 patients (15.4%) were declared dead: 532 without treatment and 162 after treatment. 10 patients (0,4%1 died during the transportation, 16 (0.6%1 patients died in the emergency room, and 579 patients 122.5%) were discharged following observation in the emergency department. 1992 patients 176,5%1 were hospitalised; 202 of these (10.5%) died during their hospital stay, while 1720 (89.5%) were discharged alive. The ambulance doctor escorted 251 patients (9.8%) to the hospital using ambulance signals and 876 patients 134,1%) without signals. 1441 patients (56.1 %I were transported by the ambulance crew alone.lt is concluded that a great propertion of the patients receive defimtlve treatment by the MICU. Hereby the patients are spared the inconvenience of transportation, and costly resources wlthin the hospital system are saved. More than 3/4 of the transported patients turn out to need hospitalisatlon.
O-28 PREHDSPITAL ADVANCED WE SUPF’ORT DEMANDS IN TM CITV OF COPENHAGEN.
O-30 (ALSI
M. Bradgaard Serensen, S. Hegskilde, 6. Oberg, H. Reich, M.E. Crawford. The Mobile Intensive Care Unit. The Municipal Hospital of Copenhagen, Copenhagen, Denmark.
EMERGENCY ROOM THORACOTOMY FOR PENETRATING TRAIIMA: ADMISSION CHARACTERISTTrS THAT PREDICT SIlKVIVA! 'ID Dl SCUARGE. R.R.Ballard ND., C.A.Kynon HBBS., Ruclrman MD. Department of Surgery, Hospital, Philadelphia, LISA.
M.M.Badellin,, MD.. Temple univereity
R.!.
The Copenhagen Mobile Intensive Care Unit (MICU) is manned by experienced anaesthesiologists and specially trained ambulance drivers from the Copenhagen Fire Department. It has been active since 1985 serving a population of 48O.OOO Inhabitants. There is one 24-hour unit and a supplementary unit operating averagely 10 h I day. When necessary the alarm centre activates the MICIJ which participates in a rendez-vous system with the local ambulances in the city.ln 1994 the MlCU was celled 5.958 times with an equal distribution of 444-571 calls per month. The weekdays were also equally busy f13.6-15.7% of the weekly calls). 60% of the calls took place during the daytime (06.OO-20.001 vs. 40% at night. In 75.2% of the calls the MICU made contact with one or more patients, the median response time being 4.8 minutes. In 8.8% of the cases the treatment could be characterized as primary life saving, in 48.6% the condition was improved, in 38.1% unchanged, wheras 4,5% of the patients deteriorated or died. 58.5% were men and 41.5% women. 5.5% were children < 15 yr. 48.2% 15-65 years old, and 42.7% > 65 years. The alarm centre was able to activate the MICU in 69% of the cases, where it was considered necessary. We conclude that there is a definite need for prehospital ALS in the city of Copenhagen. The MICU is effective with a good cost-beclefit ratio.
hospital, affect survival to hospital discharge in patients requiring emergency room thoracotomv fERT1. Method: Ketroepectivc revi& of all admissions requiciog ERT for penecracing trauma in an urban, level 1 trauma center over a six year period. Data were analyzed using the Fisher exact test. Resulte: 242 patients (age 7-78 years) raqoirrd ERT. Overall survival to discharge was 9.9% (24 cases). 12/2Db (5.B%) gunshot wounds survived to discharge compared to 12/ 36 (33%) stab wounds (p
O-29
o-31
THE PRIMARY COURSE OF PATIENTS FOLLOWING ADVANCED LIFE SUPPORT (AL% IN COPENHAGEN. B.Obera,S.Hegskilde,M.Crawford,l.Meller, MBredgaard Sorensen. The Mobile Intensive Care Unit, Municipal Hospital of Copenhagen, Copenhagen, Denmark. The Copenhagen Mobile Intensive Care Unit (MICU) is based in the centre of Copenhagen and participates in a rendez-vous system with 8-12 local ambulances serving the city. Usually the ambulance arrives at the scene of the accident or acute illness first and initiates basic life support (BLSI; when the MICU arrives a few minutes later advanced medical treatment can be given. In 1994 the MICU was called to 4.521 patients. Of these patients 2570 (56.8%) ware transported to the nearest relevant hospital. 1257 patients (27.8%) received definitive treatment by the ambulance doctor, so that hospitalisation became unneccessary. 694 patients (15.4%) were declared dead: 532 without treatment and 162 after treatment. 10 patients (0,4%1 died during the transportation, 16 (0.6%1 patients died in the emergency room, and 579 patients 122.5%) were discharged following observation in the emergency department. 1992 patients 176,5%1 were hospitalised; 202 of these (10.5%) died during their hospital stay, while 1720 (89.5%) were discharged alive. The ambulance doctor escorted 251 patients (9.8%) to the hospital using ambulance signals and 876 patients 134,1%) without signals. 1441 patients (56.1 %I were transported by the ambulance crew alone.lt is concluded that a great propertion of the patients receive defimtlve treatment by the MICU. Hereby the patients are spared the inconvenience of transportation, and costly resources wlthin the hospital system are saved. More than 3/4 of the transported patients turn out to need hospitalisatlon.