THE GOLDEN HOUR AND PREHOSPITAL TRAUMA CARE
THE GOLDEN HOUR AND PREHOSPITAL TRAUMA CARE
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DOI：
10.1016/0020-1383(94)90073-6
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发表时间：
1994-05-01
影响因子：
2.5
通讯作者：
MCNICHOLL, BP
中科院分区：
文献类型：
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作者：
MCNICHOLL, BP
在北方爱尔兰，对12家医院和大约100万人进行了为期1年的前瞻性研究，以预测院前高级生命支持（ALS）对重大创伤的有效性。入选标准为创伤严重度评分（ISS）> 15分，且能活着到达医院。239例患者的平均院前时间分别为24和3.5 min。大多数患者（75%，N = 179）在10分钟内到达医院。在其他患者（25%，N = 60）中，只有1/2的患者会从院前ALS中受益。15名患者在救护车到达前吸气（平均时间为7分钟），最终死亡。70%的死亡患者，无论是吸气或呼吸暂停有严重的原发性脑损伤，其他30%被认为是无法挽救的TRISS和同行评审。ALS的重大创伤将是适当的，少于50例ISS > 15每年在北方爱尔兰。护理人员很难保持技能。
A 1-year prospective study of 12 hospitals, and approximately 1 million people, was carried out to predict the effectiveness of prehospital advanced life support (ALS) for major trauma in Northern Ireland. Inclusion criteria were an Injury Severity Score (ISS) > 15 and reaching hospital alive.Two hundred and thirty-nine patients had mean prehospital times of 24 and 3 5 min for urban and rural hospitals, respectively. Most patients (75 per cent, N = 179) were within 10 minutes of a hospital. Of the other patients (25 per cent, N = 60), only 1/2 would have benefitted from prehospital ALS. Fifteen patients aspirated (for a mean time of 7 minutes) before ambulance arrival and eventually died. Seventy per cent of patients who died and who either aspirated or were apnoeic had severe primary brain injuries; the other 30 per cent were considered unsalvageable by both TRISS and peer review.ALS for major trauma will be appropriate for less than 50 patients with ISS > 15 per annum in Northern Ireland. Skill maintenance will be difficult for paramedics.