Helicopter emergency medical rescue for the traumatized: experience in the metropolitan region of Campinas, Brazil.

Ricardo Galesso Cardoso,Carina Fontana Francischini,Ricardo Vanzetto,Jorge Michel Ribera,Gustavo Pereira Fraga

doi:10.1590/0100-69912014004003

Ricardo Galesso Cardoso, Carina Fontana Francischini + Show 3 more

Open Access

https://doi.org/10.1590/0100-69912014004003

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Abstract

To analyze the profile of patients served by the air medical rescue system in the Metropolitan Region of Campinas, evaluating: triage and mobilization criteria; response time; on-site care and transport time; invasive procedures performed in the Pre-Hospital Care (PHC); severity of patients; morbidity and mortality. We conducted a prospective, descriptive study in which we analyzed medical records of patients rescued between July 2010 and December 2012. During this period, 242 victims were taken to the HC-Unicamp. Of the 242 patients, 22 were excluded from the study. of the 220 cases evaluated, 173 (78.6%) were male, with a mean age of 32 years. Blunt trauma was the most prevalent (207 cases - 94.1%), motorcycle accidents being the most common mechanisms of injury (66 cases - 30%), followed by motor vehicle collisions (51 cases - 23.2%). The average response time was 10 ± 4 minutes and the averaged total pre-hospital time was 42 ± 11 minutes. The mean values of the trauma indices were: RTS = 6.2 ± 2.2; ISS = 19.2 ± 12.6; and TRISS = 0.78 ± 0.3. Tracheal intubation in the pre-hospital environment was performed in 77 cases (35%); 43 patients (19.5%) had RTS of 7.84 and ISSd"9, being classified as over-triaged. Of all patients admitted, the mortality was 15.9% (35 cases). studies of air medical rescue in Brazil are required due to the investments made in the pre-hospital care in a country without an organized trauma system. The high rate of over-triage found highlights the need to improve the triage and mobilization criteria.

Highlights

It is known that the survival of a trauma victim is directly related to the speed with which the same is subjected to the appropriate definitive treatment 1
We assessed medical charts and records of patients treated between July 2010 and December 2012
Efforts are made to avoid the occurrence of errors, which can both be classified as “undertriage”, a situation in which patients with severe injuries are classified as having mild trauma, generating a significant increase in morbidity and mortality, as well as overtriage, which occurs when victims with less serious injuries are classified as having more severe ones, resulting in overload of the highcomplexity care reference services, and an increase in the costs involved in patient care, as well as leading to greater exposure, both of patients and teams, to the risks inherent of the use of the aircraft in this type of mission

Summary

Introduction

It is known that the survival of a trauma victim is directly related to the speed with which the same is subjected to the appropriate definitive treatment 1. If the patient with serious injuries enters the emergency room and undergoes surgery in the shortest possible time, survival chances will be much greater, since the effective control of bleeding is earlier, and the trauma-related coagulopathy and hypothermia will have lower chances of ensuing permanently. Faced with this reality, the need for rapid and appropriate care in the pre-hospital phase is imperative. In the Vietnam War that number increased to more than 370,000 soldiers 4

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