760例“5·12”汶川地震伤员的直升机转运

Experience of transfer of 760 tramna patients with helicopter after the Wenchuan Earthquake

汶川地震发生后第3天起，政府和军队每天出动90架直升机，大量伤员采用直升机空中转运至相距仅百余公里的成都市。四川大学华西医院于2008年5月14日至21日转运接收了来自汶川、映秀、茂县、北川、理县、绵竹等地区近30批次的伤员共760名。直升机转运患者具有快速、灵活、不受地形条件限制，与地面运送相比，空运途中的“致伤性”大为减少。但由于直升机上机舱高度低，医务人员的工作空间非常有限；飞行的不稳定性为医疗护理工作带来一定困难；起飞降落时速度迅速变化使得失重与超重给患者带来一系列生理变化，如胸腔压力的改变可能加重伤情；且汶川地处山区密林，直升机在执行任务时有飞行风险。直升机首先转运“潜在可治疗的患者”（没有受到迅速致死性创伤的患者），在转运过程中要防止发生危及生命的情况（如窒息、持续抽搐、休克），同时还要注意气道管理，观察生命体征的变化，进行必要的言语安慰等。直升机到达机场后，接机的医护人员先评价气道是否阻塞、生命体征是否平稳、有无危及伤员生命而需要紧急处理的情况。如有上述情况者在现场做紧急处理稳定后，再转送到距机场最近、有救治条件的医院急救。在救护车上除观察病情变化外，还详细登记伤员的姓名、年龄、联系方式等一般资料，在未有伤口的暴露皮肤处贴上小标签，简单描述一般资料和初步诊断。现场伤员的拣选以及接机时的紧急处置是短程直升机成功转运的重要条件。

From the third day after Wenchuan Earthquake, the Chinese government and army dispatched 90 helicopters per day to transport the wounded to Chengdu City （about 100 km away from earthquake-hit area） .From 14 May to 21 May 2008, West China Hospital of Sichuan University received totally 760 wounded mainly from Wenchuan, Yingxiu, Maoxian, Beichuan, Lixian, Mianzu. Transfering patients by helicopter is characterized by rapid,flexible and non-restriction from terrain conditions. Compared with transfer on the land,injury induced during the transfer is reduced. However, the height of helicopter cabin is low, so it＇s difficult for doctors to carry out related treatment works. The instabihty during the flight also brought a lot of difficulties for the medical care. The rapid change of speed during take-off and landing caused a series of physiological changes on patients, such as thoracic pressure. Wenchuan is located in the mountains, and this also brought difficulties for the flight. The potentially savable victims, whose lives wouldn＇t be threatened with bad wound and wouldn＇ t die in a short time,should be given the priority of transfer by helicopter. During the trip of transfer, the life-threatening occurrences, such as asphyxia, persistent convulsion and shock, were well prevented. At the same time, airway management,monitoring of vital signs and necessary consolation were important. After arrival at airport, the medical staff waiting at airport should watch and evaluate the patency of airway and vital signs carefully. If the airway obstruction,vital signs unstable and some other critical events are identified, the first aid at airport is essential. When patients are stable,they can be transported to the nearest hospital where the emergency treatment is available. Besides observation of patients＇ condition, registration of the name, age, address and the phone number of casualties should be done in the ambulance. Stick a label of the general information and the preliminary diagnosis of the patient on bare intact skin. The selection of casualties before transfer and the first aid at the airport are very important for successful short distance trip by helicopter.