固定翼医疗专机在成批严重烧伤伤员长途转运中的应用经验

Experience of transportation of mass severe burn patients for long distance by air ambulance with fixed wing

目的探讨应用固定翼医疗专机长途转运成批严重烧伤伤员的经验。方法回顾和分析使用固定翼医疗专机转运2017年5月2日大兴安岭特大森林火灾5例伤员至笔者单位的组织和实施过程。本组伤员均为重度烧伤伴有吸入性损伤。事故发生后4 h相关部门立即召集烧伤学专家2人、重症医学专家1人、烧伤重症监护病房（ICU）护士长1人组成国家医疗队行转运前救治，其中3例患者行气管切开术、4例患者行焦痂切开减张术。转运前按照方案就患者、家属、转运专家组专家和机组成员等方面完善各项安排，转运中充分利用医疗专机相应设备做好患者的监护和治疗，到达机场后经绿色通道到达笔者单位烧伤ICU。结果本组5例伤员于伤后26～44 h分4批应用固定翼医疗专机长途转运单程1 700 km，空中飞行单程3.5 h安全到达目的地，并从停机坪直接送至笔者单位烧伤ICU。伤员转运途中病情平稳，后续抢救顺利，在3个月内出院。结论成批严重烧伤伤员使用固定翼医疗专机长途转运是可行的，按照规范化流程实施转运更加安全有效，转运时机可提前到休克期内。

Objective To explore the experience of transportation of mass severe burn patients for long distance by air ambulance with fixed wing.MethodsThe organization and implementation process of transportation of 5 patients in the devastating forest fire of Greater Khingan on 2nd, May 2017, for long distance by air ambulance with fixed wing were reviewed and analyzed. All the patients were severely burned and complicated with inhalation injury. Four hours after accident, the relevant authority dispatched national medical team with 2 specialists of burn, 1 specialist of intensive care medicine, 1 head nurse of burn intensive care unit （ICU） to treat and cure the patients before transportation. Three patients had tracheotomy and four patients had escharotomy. Patients and their relatives, expert group of transportation, and aircrew members were arranged according to the scheme before transportation. Patients were monitored and treated with the equipments of air ambulance during the transportation. Patients were transferred to the burn ICU in our hospital from the airport through the green channel.ResultsAll the five patients were transported to the destination safely for long distance of 1 700 kilometres and air flight 3.5 hours one way by air ambulance with fixed wing in 4 batches at 26 to 44 hours post burn, and transported from tarmac to burn ICU of our hospital. All the patients were in stable condition during the transportation and had successful subsequent rescue. All the patients were discharged in three months.ConclusionsIt is feasible to transfer mass severe burn patients for long distance by air ambulance with fixed wing, and it is safer and more effective to transfer according to the standardization process, and the opportunity of transportation of severe burn patients can be moved up to shock stage.