- 期刊
梨山馬拉松賽緊急醫療救護病患特徵
Emergency Medical Services in the Lishan Marathon
摘要
目的：探討台灣高海拔地區舉辦馬拉松競賽參與者尋求醫療照顧病患的特質及緊急醫療救護的需求。材料與方法：在1999年秋季，針對一項選手約600人、工作人員400人，及上萬名遊客參與的高海拔地區(1,700公尺～2,600公尺)競賽性馬拉松賽，由急診醫師及護理人員，提供緊急醫療救護的服務，以瞭解高海拔地區馬拉松賽病患的病況特質及緊急醫療救護需求。結果：從醫療人員進駐(04:30 AM)到比賽結束(10:30 AM)，共有病患18人，年齡由15歲到73歲，平均為43歲，男性有16位，女性有2位。病患以選手為主，佔13位(72.00%)，佔600位選手中之2.17%，其中8位為迷你馬拉松(15公里)跑者，5位為標準馬拉松(42.195公里)跑者；非選手佔5位(28.00%)，其中工作人員3位，遊客2位。迷你馬拉松跑者(400位)之醫療使用率為2.00%，標準馬拉松賽(200位)為2.50%。運動員病患中病患的病況以腿部肌肉痙攣最多(5人，38.50%)，扭傷/拉傷4人(30.80%)，擦傷或裂傷2人(15.30%)，脫水有1人，另1人為多形性心室早發性收縮。其中屬輕度病患的有6人次(46.15%)，中度有7人次(53.85%)，所有病患經現場治療後隨即改善離去，並無任何後送情形。與1997台北國際馬拉松賽相較，梨山高地馬拉松賽之醫療使用率並沒有明顯偏高，但由於參賽者較少，仍需進一步評估。結論：我們的資料顯示雖無明顯的高山症患者，且大多數病患都只是輕度與中度病患，但仍有少數患者需要專業醫療人員的處理，故國內像這樣高海拔地區的大型競賽活動，確實有緊急醫療救護的需求。
並列摘要
Objective: To describe the patient characteristics at a marathon at high altitude in Taiwan, and to provide data for planning future events. Materials and Methods: Medical care was provided for 600 runners, about 400 workers and more than ten thousand spectators at the 1999 Lishan Marathon (altitude 1,700 m to 2,600 m ), coordinated by the Emergency Department of Veterans General Hospital-Taipei. There were four emergency physicians and eight emergency nurses. A standardized form was used to collect information including patient data, patient identification, time and place of the problems, type and causes of injuries, time and place of the problems, types and causes of injuries, time and problems related to patient visit, positive physical findings, diagnosis, treatment and disposition. Results: During the marathon (from 04:30 am to 10:30 am), eighteen patients sought medical assistance at medical stations or in the field. Of these, sixteen were males and two were females. Their ages ranged from 15 to 73 with an average of 43 years. Of the 18 patients, 13 were runners (72%), including 8 mini-marathon runners (15 km) and 5 standard marathon runners (42.195 km ), 3 were staff members and 2 were spectators. The medical use rates for the 600 runners, mini-marathon runners and standard-marathon runners were 2.17%, 2.00% and 2.50%. The most common problem was heat cramps (5 cases, 38.5%), followed by 4 cases of muscle strain and/or sprain (30.8%), 2 cases of abrasion and/or laceration (15.3%), one case of dehydration and one case of arrhythmia (multiform ventricular premature complex). The majority of patients had either minor ailments (6 cases, 46.15%) or moderate illness (7 cases, 53.85%). All patients left after being treated in the station. No patients were transferred by ambulance to the hospital. The medical use rate was similar to that of the 1997 Taipei Marathon. Since the number of runners was low, advanced studies are needed to draw firm conclusions. Conclusion: Although there were no cases of high mountain disease, and the majority of cases were minor or moderate, we found that special medical services were still needed for some patients. Therefore, a high quality, well-designed EMS system is important for mass gatherings at high altitude.