伤员医疗后送的紧急情况与处理

Emergencies in medical evacuation for wounded and handling

快速医疗后送到前线外科手术单元是提高伤员存活率的驱动力。伤员医疗后送过程中常见的紧急情况,涵盖低血压、尿少、血氧饱和度降低、心搏骤停和精神状态改变等,不确定性原因或许来自失血性休克、心包填塞、主动脉夹层、创伤性胸腔积血、创伤性腹腔积血等。医疗后送中严重伤员所需的三联治疗技能是机械通气、儿茶酚胺输注和输血的管理,对于伤员维持护理的安全性、连续性至关重要。提前计划和准备永远是伤员医疗后送的必备素养,伤员后送运载着很多设备,要确保所有装备、药品都能用、会用并放在正确的位置。设置复苏区域,并了解设备和团队能力以获得成功后送。通过基于呼吸、循环、神志、尿量等的移动监护提供生命支持,早期的给药氨甲环酸、战场输血、紧急情况下的便携超声运用等可改善伤员预后。

Rapidly transferring an injured soldier to the right frontline surgical unit as quickly as possible is the driving force for improving the survival of the wounded. The emergency situations in medical evacuation process of the wounded include hypotension, scanty urine, decreased oxygen saturation, sudden cardiac arrest and mental status changes. The cause of uncertainty may come from hemorrhagic shock, pericardial tamponade, aortic dissection, traumatic pleural hemorrhage, and traumatic hemorrhage, etc. The triple skills required for severely injured in medical evacuation refer to the management of mechanical ventilation, catecholamine infusion and blood transfusion, which is essential for the safety and continuity of the care of the wounded. Planning ahead and preparation are necessary for the wounded medical evacuation, in which a lot of equipment is delivered, and all equipment and medicines must be ensured to use and place properly. Setting up a recovery area and knowing about equipment and team capabilities are important for a successful delivery. Mobile monitoring such as breathing, circulation, consciousness, urine volume, early administration of tranexamic acid, battlefield blood transfusion, and portable ultrasound in emergency situations can provide the life support and improve the prognosis of the wounded.