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Hems vs. Ground-bls care in traumatic cardiac arrest.

机译：创伤性心脏骤停中的下摆与地面bls护理。

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Objective. To assess whether a top-level type of prehospital care, made of helicopter, physician, and advanced life support (ALS) procedures, improves the outcome of blunt trauma victims found in cardiac arrest (CA) as compared with a simpler type, composed of ground ambulance, nurse, and expanded basic life support (BLS). Methods. This was a cohort study from the data set of a prospective, population-based, 12-month study targeting the 1,200,000 inhabitants of the Italian region Friuli Venezia Giulia. Results. Fifty-six victims received the higher level of care (helicopter emergency medical services [HEMS] group) and 73 received the lower one (ground-BLS group). The two groups were homogeneous for mechanism of injury, gender, and time interval before cardiopulmonary resuscitation (CPR). Age was lower in the ground-BLS group. The percentage of patients in which CPR was attempted was significantly higher in the HEMS group (43% vs. 20%; CI 0.061 to 0.379). On-scene return of spontaneous circulation (ROSC) was also more likely in the HEMS group (37.5% of attempted CPRs vs. 6.6%; CI 0.027 to 0.591). None of the patients evacuated from the scene without ROSC ever attained it in hospital. This policy was virtually exclusive to the ground-BLS group. Survival to hospital discharge was 3.5% (severely disabled) in the HEMS group and 0% in the ground-BLS group (CI -0.008 to 0.078). Conclusion. A top-level type of prehospital care had significantly more chances to resuscitate blunt trauma victims found in CA as compared with a simpler level. No significant benefit on long-term outcome was found, but more cases might be needed in future studies because of the inevitably low number of survivors.
机译：目的。为了评估由直升机，医师和高级生命支持（ALS）程序制成的顶级院前护理类型是否比由以下组成的较简单类型的心跳骤停（CA）方法改善了在心脏骤停（CA）中发现的钝性创伤受害者的结果：地面救护车，护士和基本生活支持（BLS）。方法。这是一项针对前瞻性，基于人群，为期12个月的研究的数据集，该研究针对意大利地区弗留利·威尼斯·朱利亚（Friuli Venezia Giulia）的1,200,000居民。结果。五十六名受害者得到了更高水平的护理（直升机紧急医疗服务[HEMS]组），而73名则得到了较低的护理（地面BLS组）。两组在损伤机制，性别和心肺复苏前的时间间隔（CPR）方面均相同。地面BLS组的年龄较低。 HEMS组尝试进行心肺复苏术的患者百分比显着更高（43％比20％; CI为0.061至0.379）。自发循环（ROSC）的现场恢复也很可能发生在HEMS组中（37.5％的尝试CPR与6.6％的CI相对; CI为0.027至0.591）。没有ROSC的患者都没有在现场撤离。这项政策实际上是地面BLS组专有的。 HEMS组到医院出院的存活率为3.5％（严重残疾），而地面BLS组为0％（CI -0.008至0.078）。结论。与更简单的级别相比，顶级的院前护理类型具有更大的机会来挽救CA中发现的钝性创伤受害者。长期结果未见明显获益，但由于幸存者人数不可避免，未来的研究可能需要更多病例。

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