Acil Servise Helikopter Ambulans İle Getirilen Hastaların REMS ve NACA Skoruna Göre Değerlendirilmesi
Öz
Amaç: Kara yolu ile ulaşımın zor veya imkânsız olduğu durumlarda uygun hava koşullarında hastaların kurtarılması ve ilk yardımın ulaştırılması için hava yolu ambulansları kullanılmaktadır. Modern sağlık hizmetlerinde hava ambulansları vazgeçilmezdir. Hava ambulansları; hızlı, güvenilir ve ihtiyacı olan hastalara erken müdahele açısından çok kıymetli olmakla birlikte maliyeti yüksek bir hizmettir. Bizim bu çalışmada amacımız hava ambulansı hizmetine karar verilirken sık kullanılan NACA skorlamasının yanında daha objektif kriterlerin kullanıldığı REMS skorunun da kullanılabilirliğini ve etkinliğini göstermektir.
Gereç ve Yöntemler: Çalışmamızda Hastanemiz Acil Servisine Ocak 2014 –Aralık 2016 yılları arasında hava ambulansı ile vaka olarak veya diğer sağlık merkezlerinden sevkli getirilen 77 hasta retrospektif olarak incelenmiştir. Veriler SPSS (Statistical Package For The Social Scienses) 23.0 programına yüklenerek istatistiksel analizleri yapıldı.
Bulgular: Ölen hastalarla yaşayan hastaların ortanca NACA değerleri arasında istatistiksel olarak anlamlı fark vardır (p<0,001). Ölenlerde ortanca değer 6 iken yaşayanlarda 2 olarak elde edilmiştir. Çalışmamızda REMS skorları ortanca değeri de ölenlerle yaşayanlara göre istatistiksel olarak anlamlı farklılık tespit edilmiştir. (p<0,001). Ölenlerde ortanca değer 17.5 iken yaşayanlarda 3 olarak elde edilmiştir.
Sonuç: Helikopter Ambulans hizmeti öncesi hastaların değerlendirilmesinde NACA skorlaması ile birlikte REMS skorunun da kullanılması; Sağlık personelinin daha etkin ve doğru karar vermesini sağlayacaktır.
Anahtar Kelimeler
Helikopter Acil Sağlık Hzimeti Helikopter Ambulansı REMS Skoru NACA Skoru
Kaynakça
- 1T.C. Sağlık Bakanlığı Ambulanslar Ve Acil Sağlık Araçları İle Ambulans Hizmetleri Yönetmeliği (2006) Resmi Gazete Sayısı:26369.
- Bart Elias, Safety Aviation. Improved Data Collection Needed for Effective Oversight of Air Ambulance Industry. Avıatıon Safety; (2007).
- McGinnis, K., and T. Judge. "Air Medicine: Accessing the Future of Health Care." (2006).
- Woodward GA, King BR, Garrent AL, et al. Prehospital care. In: Textbook of Pediatric Emergency Medicine, 5th, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott, Williams, & Wilkins, Philadelphia 2006. p.93.
- T.C. Sağlık Bakanlığı Ambulans Hava Aracı İşletmesine Dair Esaslar Sayı: B.10.0.TSH.0.16.08.
- Olsson T, Terént A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for in hospital mortality in nonsurgical emergency department patients. Journal of internal medicine, 2004; 255(5), 579-87.
- Olsson T, Lind L. Comparison of the rapid emergency medicine score and APACHE II in nonsurgical emergency department patients. Academic emergency medicine, 2003; 10(10), 1040-48.
- Raatiniemi L, Liisanantti J, Tommila M, et al. Evaluating helicopter emergency medical missions: a reliability study of the HEMS benefit and NACA scores. Acta Anaesthesiologica Scandinavica, 2017; 61(5), 557-65.
- Tsuchiya A, Tsutsumi Y, Yasunaga H. Outcomes after helicopter versus ground emergency medical services for major trauma--propensity score and instrumental variable analyses: a retrospective nationwide cohort study. Scandinavian journal of trauma, resuscitatio, 2016;24:140.
- McQueen C, Smyth M, Fisher J, et al. Does the use of dedicated dispatch criteria by Emergency Medical Services optimise appropriate allocation of advanced care resources in cases of high severity trauma? A systematic review. Injury, 2015; 46(7), 1197-206.
- Diaz MA, Hendey GW, Bivins HG. When is the helicopter faster? A comparison of helicopter and ground ambulance transport times. Journal of Trauma and Acute Care Surgery, 2005; 58(1): 148-53.
- Brown JB, Stassen NA, Bankey PE, et al. Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury. Journal of Trauma and Acute Care Surgery, 2010; 69 (5): 1030-36.
- Gosteli G, Yersin B, Mabire C, et al. Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports. Injury, 2016; 47(7), 1414-20.
- Pasquier M, Geiser V, De Riedmatten M, et al. Helicopter rescue operations involving winching of an emergency physician. Injury, 2012; 43(9), 1377-80.
- Andruszkow H, Hildebrand F, Lafering R, et al. Ten years of helicopter emergency medical services in Germany: Do we still need the helicopter rescue in multiple traumatised patients?. Injury, 2014; 45: 53-8.
- Lairet J, King J, Vojta L, et al. Short-term outcomes of US Air Force Critical Care Air Transport Team (CCATT) patients evacuated from a combat setting. Prehospital Emergency Care, 2013; 17(4), 486-90.
- Yoon YH, Moon SW, Lee SW, et al. Helicopter emergency medical services: a report on the current status in a metropolitan area of South Korea. European Journal of Emergency Medicine, 2011; 18(3), 176-78.
Evaluation of The Patients Brought to The Emergency Service by Helicopter Ambulance by REMS and NACA Score
Öz
Aim: Air ambulances are used to save patients and deliver first aid where it is hard or impossible to access by land under favorable weather conditions. Air ambulances are indispensable in modern health care services. Air ambulance services are invaluable in terms of being fast and reliable and providing early response to the patients in need as well as being costly. In this study, the aim is to demonstrate availability and efficiency of REMS score as well as NACA score that are frequently used in making a decision on using air ambulance services.
Material and Methods: In this study, 77 patients that were dispatched to the emergency service of our hospital by air ambulance between January 2014 – December 2016 as a case or from other health centers were evaluated retrospectively. The data were statistically analysed after they were uploaded to the program SPSS (Statistical Package for The Social Scienses) 23.0.
Results: While median NACA value is 6 in the exitus cases, it is 2 in the surviving cases; there is a statistically significant difference in the median NACA values between the two groups (p<0,001). While median REMS value is 17.5 in the exitus cases, it is 3 in the surviving cases; there is a statistically significant difference in the median REMS values between the two groups (p<0,001).
Conclusion: Use of REMS score together with NACA score in evaluation of patients prior to helicopter ambulance service enables the health personnel to make more efficient and accurate decisions.
Anahtar Kelimeler
Helicopter Emergency Health Service Helicopter Ambulance REMS Skore NACA Skore
Kaynakça
- 1T.C. Sağlık Bakanlığı Ambulanslar Ve Acil Sağlık Araçları İle Ambulans Hizmetleri Yönetmeliği (2006) Resmi Gazete Sayısı:26369.
- Bart Elias, Safety Aviation. Improved Data Collection Needed for Effective Oversight of Air Ambulance Industry. Avıatıon Safety; (2007).
- McGinnis, K., and T. Judge. "Air Medicine: Accessing the Future of Health Care." (2006).
- Woodward GA, King BR, Garrent AL, et al. Prehospital care. In: Textbook of Pediatric Emergency Medicine, 5th, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott, Williams, & Wilkins, Philadelphia 2006. p.93.
- T.C. Sağlık Bakanlığı Ambulans Hava Aracı İşletmesine Dair Esaslar Sayı: B.10.0.TSH.0.16.08.
- Olsson T, Terént A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for in hospital mortality in nonsurgical emergency department patients. Journal of internal medicine, 2004; 255(5), 579-87.
- Olsson T, Lind L. Comparison of the rapid emergency medicine score and APACHE II in nonsurgical emergency department patients. Academic emergency medicine, 2003; 10(10), 1040-48.
- Raatiniemi L, Liisanantti J, Tommila M, et al. Evaluating helicopter emergency medical missions: a reliability study of the HEMS benefit and NACA scores. Acta Anaesthesiologica Scandinavica, 2017; 61(5), 557-65.
- Tsuchiya A, Tsutsumi Y, Yasunaga H. Outcomes after helicopter versus ground emergency medical services for major trauma--propensity score and instrumental variable analyses: a retrospective nationwide cohort study. Scandinavian journal of trauma, resuscitatio, 2016;24:140.
- McQueen C, Smyth M, Fisher J, et al. Does the use of dedicated dispatch criteria by Emergency Medical Services optimise appropriate allocation of advanced care resources in cases of high severity trauma? A systematic review. Injury, 2015; 46(7), 1197-206.
- Diaz MA, Hendey GW, Bivins HG. When is the helicopter faster? A comparison of helicopter and ground ambulance transport times. Journal of Trauma and Acute Care Surgery, 2005; 58(1): 148-53.
- Brown JB, Stassen NA, Bankey PE, et al. Helicopters and the civilian trauma system: national utilization patterns demonstrate improved outcomes after traumatic injury. Journal of Trauma and Acute Care Surgery, 2010; 69 (5): 1030-36.
- Gosteli G, Yersin B, Mabire C, et al. Retrospective analysis of 616 air-rescue trauma cases related to the practice of extreme sports. Injury, 2016; 47(7), 1414-20.
- Pasquier M, Geiser V, De Riedmatten M, et al. Helicopter rescue operations involving winching of an emergency physician. Injury, 2012; 43(9), 1377-80.
- Andruszkow H, Hildebrand F, Lafering R, et al. Ten years of helicopter emergency medical services in Germany: Do we still need the helicopter rescue in multiple traumatised patients?. Injury, 2014; 45: 53-8.
- Lairet J, King J, Vojta L, et al. Short-term outcomes of US Air Force Critical Care Air Transport Team (CCATT) patients evacuated from a combat setting. Prehospital Emergency Care, 2013; 17(4), 486-90.
- Yoon YH, Moon SW, Lee SW, et al. Helicopter emergency medical services: a report on the current status in a metropolitan area of South Korea. European Journal of Emergency Medicine, 2011; 18(3), 176-78.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Orijinal Çalışma |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2021 |
| Yayımlandığı Sayı | Yıl 2021 Cilt: 4 Sayı: 1 |
