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Scene transport of pediatric patients injured at winter resorts.

机译：在冬季度假胜地受伤的小儿患者的现场运输。

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Objective. To examine the characteristics of pediatric patients (age =16 years) injured at winter resort scenes and transported by helicopter emergency medical services (HEMS) or ground EMS (GEMS) ambulance services to regional trauma centers. Methods. Between 1997 and 2001, a total of 119 patients (GEMS = 69; HEMS = 50) were identified from trauma registries and HEMS transport records. Demographic data, initial vital signs, hospital interventions, and discharge status of the two groups were examined. Results. The distributions of gender, initial vital signs, Injury Severity Score (ISS; either = or > 15), intensive care unit (ICU) length of stay (LOS), total hospital LOS, and home discharge status were similar between the two groups (p = 0.05). Patients transported by HEMS were older (14 +/- 2 vs. 10 +/- 4, p < 0.001), less likely to be admitted to the hospital (73% vs. 98.5%; p < 0.001), and more likely to have multiple injuries [13 (27%) vs. 8 (11.6%), p = 0.032]. The GEMS patients had a higher rate of isolated extremity [33 (80.5%) vs. 8 (19.5%)] and thoracoabdominal [11 (73.3%) vs. 4 (26.7%)] injuries. The high orthopedic injury rate in the GEMS patients contributed to a higher rate of surgery in this group (45% vs. 24%, p = 0.028). Regardless of transport mode, patients requiring immediate interventions (intubation, chest tube placement, or blood product administration) had either a depressed level of consciousness (GCS = 12) on emergency department arrival or thoracoabdominal injuries. No deaths were recorded. Conclusions. Patients transported by HEMS and GEMS had similar hospital characteristics but different injury patterns. A prospective study examining the initial triage of pediatric patients injured at winter resorts would help to determine which subset of patients are best served by HEMS transport.
机译：目的。检查在冬季度假胜地受伤并由直升飞机急诊医疗服务（HEMS）或地面EMS（GEMS）救护车运送到地区创伤中心的儿科患者（年龄= 16岁）的特征。方法。在1997年至2001年之间，从创伤登记处和HEMS运输记录中总共鉴定出119名患者（GEMS = 69; HEMS = 50）。检查了两组的人口统计学数据，初始生命体征，医院干预措施和出院状况。结果。两组的性别，初始生命体征，损伤严重程度评分（ISS;等于或大于15），重症监护病房（ICU）住院时间（LOS），总住院LOS和出院状况的分布相似（ p = 0.05）。 HEMS转运的患者年龄较大（14 +/- 2 vs. 10 +/- 4，p <0.001），入院的可能性较小（73％vs. 98.5％; p <0.001），并且更有可能多处受伤[13（27％）vs. 8（11.6％），p = 0.032]。 GEMS患者的孤立四肢受伤率较高（33（80.5％）比8（19.5％）]和胸腹损伤[11（73.3％）比4（26.7％）]更高。 GEMS患者中较高的骨科损伤率促使该组的手术率更高（45％对24％，p = 0.028）。无论采用哪种运输方式，需要立即进行干预（气管插管，放置胸管或输注血液）的患者在急诊室到达时或胸腹受伤时意识水平均下降（GCS = 12）。没有死亡记录。结论。由HEMS和GEMS转运的患者具有相似的医院特征，但损伤方式不同。一项前瞻性研究，检查在冬季度假胜地受伤的小儿患者的初始分类，这将有助于确定哪些患者子集最适合通过HEMS运输。

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