新英格兰医学杂志2014-01-06 1:45 AM

Outcomes of Medical Emergencies on Commercial Airline Flights 商业航班医疗急救的结果分析

Abstract
Background
Worldwide, 2.75 billion passengers fly on commercial airlines annually. When in-flight medical emergencies occur, access to care is limited. We describe in-flight medical emergencies and the outcomes of these events. 背景 世界范围内,每年有27.5亿人乘坐商业航空飞机。 当飞机内医疗急救事件发生时, 能获得的护理是有限的。 我们描述了飞机内医疗急救事件和这些事件的结果。
Methods
We reviewed records of in-flight medical emergency calls from five domestic and international airlines to a physician-directed medical communications center from January 1, 2008, through October 31, 2010. We characterized the most common medical problems and the type of on-board assistance rendered. We determined the incidence of and factors associated with unscheduled aircraft diversion, transport to a hospital, and hospital admission, and we determined the incidence of death. 方法 我们回顾了2008年1月1日到2010年10月31日五家国内和国际航空公司飞机内医疗紧急呼叫医疗通讯中心的通话记录。 我们说明了最常见的医疗问题和飞机上提供的援助的类型。 我们确定了发病率和计划外的飞机改道,转入医院就诊并住院的相关因素,并且我们确定了死亡的发生率。
Results
There were 11,920 in-flight medical emergencies resulting in calls to the center (1 medical emergency per 604 flights). The most common problems were syncope or presyncope (37.4% of cases), respiratory symptoms (12.1%), and nausea or vomiting (9.5%). Physician passengers provided medical assistance in 48.1% of in-flight medical emergencies, and aircraft diversion occurred in 7.3%. Of 10,914 patients for whom postflight follow-up data were available, 25.8% were transported to a hospital by emergency-medical-service personnel, 8.6% were admitted, and 0.3% died. The most common triggers for admission were possible stroke (odds ratio, 3.36; 95% confidence interval [CI], 1.88 to 6.03), respiratory symptoms (odds ratio, 2.13; 95% CI, 1.48 to 3.06), and cardiac symptoms (odds ratio, 1.95; 95% CI, 1.37 to 2.77). 结果 一共有11920次飞机内医疗急救事件导致了和医疗通讯中心的通话(每604次飞行有一次医疗急救)。最常见的问题是晕厥或晕厥(占37.4 %),呼吸道症(12.1 %),恶心或呕吐(9.5 %)。48.1%的飞机内医疗急救事件得到了医师乘客提供的医疗协助, 有7.3%的飞行因此进行了飞机改道。 10914位飞行后随访数据可用的病人中,25.8%的人被紧急医疗服务人员转移到了医院, 8.6%的人好转,0.3%的人死亡。 最常见的住院的病症是可能的中风(比值比为3.36 ,95%可信区间, 1.88~6.03),呼吸道症状(比值比为2.13 ,95%可信区间,1.48〜 3.06 ) ,和心脏症状(比值比1.95 ,95%可信区间,1.37〜 2.77 ) 。
Conclusions
Most in-flight medical emergencies were related to syncope, respiratory symptoms, or gastrointestinal symptoms, and a physician was frequently the responding medical volunteer. Few in-flight medical emergencies resulted in diversion of aircraft or death; one fourth of passengers who had an in-flight medical emergency underwent additional evaluation in a hospital. (Funded by the National Institutes of Health.) 结论 大部分飞机内医疗急救和晕厥,呼吸道症状,或胃肠道症状相关, 并且医师乘客是经常志愿提供医疗协助。 少数的飞机内紧急医疗事件导致飞机改道或者死亡。 四分之一进行了飞机内医疗急救的乘客去了医院接受进一步的诊断。 (美国国立卫生研究院资助)

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