- 期刊
- OpenAccess
【論文摘要】重機騎士車禍拋飛「土下座」昏迷：特殊姿勢之頸椎保護案例報告
【論文摘要】How The EMT Extricate An TA Major Trauma Patient With The Uncommon Pose "Dogeza"
摘要
背景：根據統計，近5年機車肇事件數逐年上升，尤以大型重型機車肇事比率偏高，因機車車體材質脆弱，機車駕駛除安全帽外鮮有其他防護裝備，一旦發生交通事故，高能量機轉下易導致較嚴重傷亡，而頭部傷害及頸椎傷害便是造成癱瘓或死亡的主要原因。個案簡介：本案為44歲男性，自山區騎乘重型機車下山與廂型車發生事故。現場傷者意識昏迷，呈現「土下座」姿態，雙側上、下肢多處變形、骨盆不穩固合併有休克情形。救護人員到場後遵循頸椎保護原則，活用各單項頸椎保護技術將患者安全移動至長背板上固定，另給予骨折固定後送往急救責任醫院救治。結果：傷者到院後直入急救區，意識昏迷給予氣管內管插管，影像檢查發現右前臂開放性骨折、左側股骨封閉性骨折、骨盆骨折及腹內出血，後續收治加護病房治療並於當晚恢復清醒。結論：因應不同事故現場狀況多變，救護人員應具備因地、因時制宜的處置能力，在符合頸椎保護原則下，綜合應用七大頸椎保護術，可避免傷者二次傷害、提升傷者預後。
關鍵字
無資料並列摘要
Background: The traffic accident rate of motorcycles increases year by year. Fragile material of the motorcycles and lacking of the protective equipment contributed to fatal injuries. The cervical spine injury (TSI) is main cause of motorcycle accidents fatal injuries. Case description: In this case, a 44years old male rider had major trauma following a two-vehicle collision. The patient was unconscious with an uncommon pose, which was recognized as "Dogeza". Both vehicles were destroyed badly. EMTs took actions such as spinal immobilization, pelvic binders, splinting of fractures, and urgently send to the emergency hospital. This case report is aim to describe how to extricate the patient from the uncommon pose. Results: EMTs notified the receiving hospital that a trauma patient was en route. The unconscious patient was aggressively resuscitated with blood transfusion and placed in an endotracheal tube in the hospital. The injuries that the patient suffered are as followed: right forearm open fracture, left femur shaft fracture, intraperitoneal hemorrhage, and pelvic fracture. After resuscitation, this patient's consciousness was alert and vital signs were stabled in the ICU. Conclusion: EMTs will face various scene on their duties, and EMTs should have the abilities to use all their techniques, such as spinal immobilization skills, and knowledges to deal with all kinds of situations. The main principles are preventing the second injury, trying to enhance the survival rate and the quality of patient's life.