Abstract
Pediatric comas are particular situations of terrestrial or aerial medical intervention, requiring knowledge of specific protocols and prioritization and hierarchy of emergency interventions. The reactivity of the comatose child is modified according to multiple biological, physiological parameters and generating pathologies. The study aims to analyze the specific elements of aerial medical interventions with helicopter, HEMS (Helicopter Emergency Medical Service) at comatose child that influences the emergency path, but especially the medium and long term prognosis of these cases. The transfer of comatose children at Galati aeromedical base, both primary and secondary interventions, were studied. The study was a prospective randomized study involving pediatric comas transferred over a 4-year course (2014-2017) according to the criteria in force. A total of 24 children between the ages of 0-18 years were transferred, with primary and secondary interventions. In the study lot, the correlations between Glasgow scores and associated pathology, epidemiological characteristics, therapeutic elements, complications and case evolution were analyzed. A profile of the patient requiring emergency intervention for the comatose state was created, making it possible to predict the services they will need and to design the specialized interventions that will follow the transfer of these patients. Although still intensely disputed due to cost considerations, the air transfer of the comatose child facilitates a more prompt response of medical systems to manage this type of emergency and presents management particularities in pre-hospital. Based on this type of results, a strategy takes shape by which the Romanian emergency system aligns with the continuous improvement of life-saving interventions for children.
Highlights
For any patient who has suffered an injury and has his/her general state influenced, it is important to manage the time required both for intervention at the destabilizing event site and for bringing it to a near hospital as soon as possible
It was wanted to highlight the optimal reaction times, the flight schedule and the flight routes were chosen under the Bucharest air traffic control and it was taken into account the weather conditions to offer the possibility of timely intervention and no accidents and incidents according to the legislation in force on the Romanian territory
A patient who is not comatose Patient transferred by terrestrial means A comatose patient ready for transfer but deceased before the transfer We have evaluated the vital functions
Summary
24 children with coma carried by helicopter were surveyed between 2014-2017, at the Galaţi Aeromedical Base. It was wanted to highlight the optimal reaction times, the flight schedule and the flight routes were chosen under the Bucharest air traffic control and it was taken into account the weather conditions to offer the possibility of timely intervention and no accidents and incidents according to the legislation in force on the Romanian territory. The inclusion criteria in the analyzed group were: Child under 18 years old A patient in coma when picked up by the helicopter crew Patient transferred by medical helicopter Base of operation Galati Exclusion criteria: Patient aged over 18. It were applied partition classes according to the age, gender, origin according to the aeromedical point, major pathologies, comorbidities, reaction times. Patients were evaluated using the Glasgow Scale at the time of take-over, parameters of vital functions were taken, respiratory rate, tension, SaO2.
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