直升机附加综合急救医疗单元总体技术方案研究
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摘要
救护直升机因其机动灵活、反应快速,受地形、气象条件制约小等特点,得到世界各国医疗救治机构的重视和应用。但是由于我国目前直升机的数量有限,通过对现有直升机改装,形成专用救护直升机仍有困难。因此本课题研究在不改装现有运输直升机的前提下,设计研究一种直升机附加综合急救医疗单元,满足重症伤员现场急救和后送途中连续急救及监护要求,针对性地对各种不同伤情的病人采取最合理有效的救治手段,通过模块化急救单元提高直升机空运后送的能力。
该单元将维持生命体征的必须设备如:呼吸复苏、循环复苏、供氧等进行综合集成,可实现对重症伤员心肺复苏、机械通气、人工气道建立与管理、电复律与心脏除颤、持续心电、血氧、血压、体温等信息的监测。对病情进行连续、动态的定性和定量观察,并通过有效的干预措施,为重症伤员提供规范的、高质量的生命支持,改善生存质量。
该单元研究设计采用模块组合,设计在各模块之间互留兼容接口,且留有与目前定型配发部队使用的相关装备的兼容接口,例如与我军通用担架兼容,担架伤员不用转接可以直接加载在单元上实施救治,形成相应的综合救治装备,为挽救伤员的生命节省了宝贵的时间。单元集成的生命体征监测模块,不仅可以现场实现显示伤病员的生理信息,而且可利用internet网络将数据发送到后方救治中心,后方专家通过对伤员生命信息的观察,实现远端救护指导,并做好接收伤员的准备工作。直升机附加综合急救医疗单元主要用于平战时重症伤员的现场综合急救和后送途中维持重症伤员生命体征,可对重症伤病员实施呼吸复苏、循环复苏、心电、血压、体温、呼吸、血氧饱和度等体现生命体征信息的监护和复合伤、多处伤的紧急处置。
Ambulance helicopters have drawn much attention from the medical facilities of many countries for its advantages such as high mobility, rapid response and versatility in deferent terrain and weather conditions, which can be modified from general helicopters. As a developing country, China has no enough helicopters for modification into ambulance helicopters. Without any modification of the transportation helicopter, the added integrated medical first-aid unit of helicopter in this investigation can be applied to seriously injured patients’field first-aid and continuous treatment and monitoring during evacuation. Thus, all kinds of patients can be treated efficiently and timely, and the air evacuation of helicopters can be improved.
The unit integrates some equipment for keeping vital signs for respiration, circulation, etc to realize CPR, mechanical ventilation, establishment & management of artificial airway, electrical cardioversion, defibrillation as well as continuous monitoring for ECG, blood oxygen, blood pressure and body temperature. Accordingly, life support can be implemented on seriously injured patients to enhance their life quality.
Modularization technology is applied to this unit to make all modules of the unit interfaced with each other. The unit can also interface with issued equipment, e.g. general stretcher. The integrated vital signs monitoring module can display patients’physiological information on the spot and transmit related data to the experts in rear area through Internet, then tele-instruction and preparatory work can be performed. The unit can be applied to seriously injured patients’field first-aid, keeping vital signs for CPR, ECG, blood pressure, body temperature, respiration and saturation oxygen, as well as emergency treatment of combined injury and multiple injuries.
该单元将维持生命体征的必须设备如:呼吸复苏、循环复苏、供氧等进行综合集成,可实现对重症伤员心肺复苏、机械通气、人工气道建立与管理、电复律与心脏除颤、持续心电、血氧、血压、体温等信息的监测。对病情进行连续、动态的定性和定量观察,并通过有效的干预措施,为重症伤员提供规范的、高质量的生命支持,改善生存质量。
该单元研究设计采用模块组合,设计在各模块之间互留兼容接口,且留有与目前定型配发部队使用的相关装备的兼容接口,例如与我军通用担架兼容,担架伤员不用转接可以直接加载在单元上实施救治,形成相应的综合救治装备,为挽救伤员的生命节省了宝贵的时间。单元集成的生命体征监测模块,不仅可以现场实现显示伤病员的生理信息,而且可利用internet网络将数据发送到后方救治中心,后方专家通过对伤员生命信息的观察,实现远端救护指导,并做好接收伤员的准备工作。直升机附加综合急救医疗单元主要用于平战时重症伤员的现场综合急救和后送途中维持重症伤员生命体征,可对重症伤病员实施呼吸复苏、循环复苏、心电、血压、体温、呼吸、血氧饱和度等体现生命体征信息的监护和复合伤、多处伤的紧急处置。
Ambulance helicopters have drawn much attention from the medical facilities of many countries for its advantages such as high mobility, rapid response and versatility in deferent terrain and weather conditions, which can be modified from general helicopters. As a developing country, China has no enough helicopters for modification into ambulance helicopters. Without any modification of the transportation helicopter, the added integrated medical first-aid unit of helicopter in this investigation can be applied to seriously injured patients’field first-aid and continuous treatment and monitoring during evacuation. Thus, all kinds of patients can be treated efficiently and timely, and the air evacuation of helicopters can be improved.
The unit integrates some equipment for keeping vital signs for respiration, circulation, etc to realize CPR, mechanical ventilation, establishment & management of artificial airway, electrical cardioversion, defibrillation as well as continuous monitoring for ECG, blood oxygen, blood pressure and body temperature. Accordingly, life support can be implemented on seriously injured patients to enhance their life quality.
Modularization technology is applied to this unit to make all modules of the unit interfaced with each other. The unit can also interface with issued equipment, e.g. general stretcher. The integrated vital signs monitoring module can display patients’physiological information on the spot and transmit related data to the experts in rear area through Internet, then tele-instruction and preparatory work can be performed. The unit can be applied to seriously injured patients’field first-aid, keeping vital signs for CPR, ECG, blood pressure, body temperature, respiration and saturation oxygen, as well as emergency treatment of combined injury and multiple injuries.
引文
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1.杨造成.中国国际救援队在巴基斯坦地震救援中的医学实践与研讨.中国急救复苏与灾害医学杂志,2006,1 (2 - 3) : 75 -781.
2.吴峰,王谦,周世伟.战时伤病员医疗后送体制的现状及发展趋势.医学动物防制,2003, 19(4):199-203.
3. Galante JM. Air surgical residents prepared for mass casualty inci-dents J Surg Res, 2004, 121 (2) : 273-761.
4.都定元.美国创伤急救体系介绍.中华创伤杂志,2006,22(9):718-720.
5.张瑜.探路国外先进急救体系.当代医学,2007,(9):36-40.
6.陈发钦.法国卫生危机处理和急诊急救系统分析.中国急救复苏与灾害医学杂志,2007,2(5):281-284.
7.陆文民.德国的空中救护中心(DRF).江苏卫生保健, 2000,2(1):57.
8.德军空中、海上空中后送装备,维普资讯http://www.cqvip.com.
9.李宗浩,金辉.论中国救援医学的创立及其在国家突发公共事件中的地位.中华医学杂志,2005, 85 (22) :1519–1520.
10.熊悦安,刘厚俭.开展直升机转送危重病伤员提高城市急救功能.中华急诊医学杂志,2004 ,13(8):521-522.
11.曾友燕,桂莉.我国院前急救现状及其发展趋势.解放军护理杂志,2003 ,20(11):45-47.
12. Tess. Richards Medical Lesson form the Falkkands[J]. British Medical Journal,1983, 286(6364):650-651.
13.刘向宏,扈长茂,王新光.关于登陆作战医疗后送工具的几点思考.医疗卫生装备,2005,26(5):46-47.
14.孙巍.国内外空运医疗后送装备的发展与展望.后勤科技装备,1998(6):35-37.
15.孙巍.我军空运救护装备配套的基本原则与要求.后勤科技装备,1994(3):35-36.
16.孙巍,钟方虎,张津晖,等.SKWZ01-100空运救护装备的研制.医疗卫生装备,2004(5):32-33.
2.吴峰,王谦,周世伟.战时伤病员医疗后送体制的现状及发展趋势.医学动物防制,2003, 19(4):199-203.
3.王运斗.美军近期卫生装备的发展.解放军卫勤杂志,2001,19(3) :188.
4.郭鹏.透析美军战时医疗救护体系.甘肃科技,2004,20(8):167-169.
5.邹勇,陈贻春.直升机急救转运流程探讨.中国全科医学, 2005,8(6):481-482.
6. Buntman A J , Yeomans K A. The effect of air medical transport on survival after trauma in Johannesburg South Africa. S Afr Med J , 2002 ,92 : 807-810.
7. Nardi G, Massarutti D , Muzzi R , et al. Impact of emergency medical helicopter service on mortality for trauma in north-east Italy , A regional prospective audit. Eur J Emerg Med , 1994 , 1 : 69-77.
8. Schwartz GR ,Safar P ,Stone J H , et al . Principles and practice of e-mergency medicine[M]. 2nd ed. Philadelphia :Saunders ,1986. 17-19.
9. Major J H. The development of U. S. CAA/ FAA civil rotocraft certi-fication[J]. Vertifilite ,1984 ,(6) :33-36.
10.王林.促进现代急救中心建设的思考.中国急救复苏与灾害医学杂志,2007,2(4):202-203.
11.李向晖,侯世科,彭碧波,等.赴国外紧急医疗救援工作流程的初步探讨.中国急救医学2007,27(7):611-614.
12.化楠,杨丽凤,岳茂兴,等.首次载人航天航天员在医疗救护直升机内的护理特点及措施.解放军护理杂志,2005,22(2):91-92.
13.李向晖,程纪群,侯世科,等.印尼海啸救援中的联合转运工作[J].武警医学,2005, 16 (7) : 551– 552.
14.都定元.美国创伤急救体系介绍.中华创伤杂志,2006,22(9):718-720.
15.张瑜.探路国外先进急救体系.当代医学,2007,(9):36-40.
16.陈发钦.法国卫生危机处理和急诊急救系统分析.中国急救复苏与灾害医学杂志,2007,2(5):281-284.
17.陆文民.德国的空中救护中心(DRF).江苏卫生保健, 2000,2(1):57.
18.德军空中、海上空中后送装备,维普资讯http://www.cqvip.com.
19.李宗浩,金辉.论中国救援医学的创立及其在国家突发公共事件中的地位.中华医学杂志,2005, 85 (22) :1519–1520.
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