试论自行车、铁人三项等赛事医疗急救和转运模式

Discussion on the Patterns of EMST about Cycling and Triathlon Competition

通过总结分析三类高危体育赛事医疗急救和转运服务及急性伤病的案例资料,探索和研究行之有效的赛事医疗服务模式。应用实证研究和理论分析相结合的方法,回顾性地对1995年8月～2009年10月22场次自行车、铁人三项、摩托车赛事医疗急救和转运服务的思想理念、组织管理及赛事中突发的368例急性伤病的现场诊断救治进行了总结分析。赛事涉及国内国际、室内室外、陆地水中、高原平原、炎热寒冷、潮湿干旱、人体器械、耐力竞速、对抗性非对抗性、超长距离极短距离等因素,由政府、协会、企业等举办。急性伤病包括内科急症10类144例,外科急症7类224例;总转运率19.02%、总入院率14.40%,实现零死亡率和现场救治归队率80.98%。形成了"超前预防、安全高效、和谐顺畅"思想理念模式;"规范化、科学化和国际化"组织管理模式:遵循国际惯例政策,制定个性化预案流程,"场(馆)运行团队"下的医疗团队"一盘棋"、"三人急救单元"模式,针对性培训演练,"医疗代表"模式;"标准化和专业化"现场急救和转运模式:遵循运动医学医疗服务道德准则和急救技术标准规范等,以"先救命、后治病"为主的评估诊断、实施救治、稳定病情的现场急救总则,各类急性伤病的现场急救和转运模式,院前创伤生命支持流程。为相关赛事医疗服务确立了切实可行的模式。促使了针对生命复杂体和具有"突发性、时效性、风险性、灵活性和实用性"的赛事医疗服务更加注重超前预防和运行中的简捷顺畅、规范精确、安全高效。这些模式成为了后续服务实践的基础。

Purpose：To summarize and analyze emergency medical services and transportation （EMST） about three highly dangerous sport games, and cases of acute trauma and sickness （ ATS）, all attempts at patterns of effective games medical services are to provide reference and better service for similar games in the future. Method： By combining empirical research and theories analysis, the thought and management of 22 games EMST （Cycling, Triathlon, Motor） from 8,1995 to 10,2009,and the diagnosis and treatment of 368 cases （ATS of FOP） have been summarized and analyzed in retrospect. With overall recollection and case study, normalized, scientized, internationalized, standardized and specialized ways have been explored. Resuit：The games were involved in the factors： internal and international, indoor and outdoor, land and water,highland and lowland, hot and cold, wet and dry, body and apparatus, endurance and high-speed, opposing and non-opposing, super-long and extra-short distance, government, association or （and） enterprise, etc. ATS： （ internal medicine） ten kinds 144 cases, （ surgery） seven kinds 224 cases ; transporting rate 19.02 %, hospitalizing rate 14.4 %, zero mortal ity and FOP cure rate 80. 98%. Have formed the patterns of （1）thought：prevention first in advance, safety and high efficiency, harmony and smoothness ; （2） normalized, scientized and internationalized management： following international conventions and policies, formulating contingency plans and procedures, being of one mind of the medical team of venue operating team, First-aid unit of three persons, training and exercise in accordance with the special situations, Medical Director pattern ; （ 3 ） standardized and specialized health care i following ethical guidelines for health care in sports medicine and first-aid technical standards, curing sickness after saving life, diagnosis and treatment and stabilizing patient ＇s condition, patterns of EMST of ATS, pre-hospital trauma life support procedure. Conclusion：Feasible patterns of medical serv- ices for similar games have been established. This has impelled games medical services for the complicated body of life and with characteristics of suddenness, time effectiveness, risk, flexibility and practicality, to be paid attention to prevention first in advance, simplification and smoothness, normal and right, safety and high-efficiency. These patterns have been become the foundation of the follow-up medical service practice.