體驗大自然競賽緊急醫療救護評估

Emergency Medical Services during a Race of Mini-Eco Challenge

高偉峰(Wei-Fong Kao) ； 胡勝川(Sheng-Chuan Hu) ； 涂炳旭(Bein-Shin Twu) ； 郭健中(Chien-Chun Kuo) ； 顏鴻章(David H. Y. Yen) ； 吳哲侃(Jer-Kan Wu) ； 周逸之(Gump Ghou) ； 施美秀(Mei-Hsiu Shih) ； 李建賢(Chen-Hsen Lee)

《中華民國急救加護醫學會雜誌》 11卷3期 (2000/09) Pp. 126-132

https://doi.org/10.30018/JECCM.200009.0005

摘要

目的：研究競賽中病患的特質及緊急醫療救護的需求。方法：在1998年5月31日，針對一個有120位選手、約200位工作人員及數百位觀眾的地方多方位競賽(包括自行車、溯溪、登山、路跑、泛舟等競賽)，以預先設計的病患處置表格，記錄搜集病患資料及處置情形，以瞭解在這樣的活動中，病患的特質及緊急醫療救護的需求，並同時予以積極治療，以保障選手、工作人員、及觀眾的安全。結果：從醫療人員進駐選手村，到比賽結束，共有病患46人次，男性26人次，女性20人次，其中有九人重覆就醫，病患年齡由16歲至46歲，平均26.5±7.4歲；病患以選手佔最多有34人次(25人，74%)，其次為工作人員9人(20%)，媒體記者2人，及選手家屬1人；病患的病況以擦傷/裂傷佔最多人有22人次(46.8%)，腿部肌肉痙攣有9人(19%)扭傷/拉傷有9人次(19%)。傷患發生地點以泛舟扛艇的海邊最多有11人次(24%)，登山溯溪之有10人次(22%)，騎乖自行車途中則有8人次(17%)。傷病的嚴重度，輕傷有34人次(74%)，中度有11人次(24%)，重度有一人，初步懷疑為第四、五頸椎受傷，予以頸圈固定，後來經電腦斷顧及磁震照影檢查顯示為第三、四、五頸椎椎間盤脫出併脊髓壓迫。藥材的使用，以使用優碘者19人次(41.3%)佔最多，其次則為酸痛軟膏18人次(39.1%)。雖然大多數病患(44/46， 95.7%)，只需受過基本急救訓練的人員來處理即可，仍有少數病患(2/46，4.3%)，需受過高級救命術的人員來處理才安全。結論：時間較長、難度較高及較激裂的競賽，傷病率較高。國內舉辦各種競賽活動，仍須有完善的緊急醫療準備，以提高服務品質，保障參與人員的安全。同時，醫療人員應在比賽開始前進駐會場，甚至當第一位選手抵達時就應考慮進選手村。以本次活動最嚴重的頸椎受傷病患為例，就在比賽開始前發生，如未予及時防範，則病患很可能會在繼續活動中，發生四肢癱瘓喪失生命的慘劇，因此不可不慎。

關鍵字

緊急醫療救護 ； 體驗大自然競賽

並列摘要

Object: To study patient characterstics in a Race of Mini-Eco Challenge.Method: An one-day race, also called” Mini-Eco Challenge”, included bicycling racing, creek crossing,mountain climbing, mini-marathon and white kayaks. There were 120 althletes, about 20 staff and media workers, and hundreds of spectators. Two doctors and 4 emergency nurses were staffed at 2 ambulances and a first aid station. A standardized form was designed to abstract information of each patient visit, such as demographic date, patient identification,time and site of the events, types and causes of injuries , time and problems of patient visiting, postive physical finding, diagnoses,treatments, and dispositions. The outcome was graded as acuity scale. Each chart wad recorded by either staffed physicians or emergency nurses.Result: Of the 46 cases that included 9 revisited cases, there were 27 males and 19 females. Age ranged from sixteen to forty-six with an average of 26.5±7.4 years old. The visits included 34 by athletes (74%, 26 patients), 9(20%) by staff at service, 2 by media workers, and one by relative of athlete. The most common injueries were abrasion and/or laceration which accounted for 22 cases(46.8%). Nine patients(19%) developed lower legs cramps ans another nine (19%) developed muscle sprain and/or train. The most common spot for the events was the sea shore where white kayaks took place and 11 case got injured. Following one the list were 10 case (22%) injured during creek crossing and mountain climbing, and 8 cases (17%) during bicycle racing. Althoough the majority of cases suffered from minor ailments in need of no physician attendance, severe cases, although rare did occur. Of the 46 visits, 34 (74%) were for minor evernts, 11 (24%) were moderate. Only one was severe case who suffered from cervical spine injury with a moderate degree of cervical spinal cord compression at C34-4-5 level after a falling accident. No progression of the disease was marked after cervical collar fixation. Although basic life support was sufficient for the majority of cases (44/46, 95.7%), some cases still need advanced life support.Conclusion: Although the majority of cases suffered from only minor ailments without the need for physican attendance, severe cases was possible occure. Injury rate was higher in a polonged, complicated and difficult race. Muscle cramps were more often in young athletes who underwent a prolonged and difficult racing game lasting more than four hours. The use rate of medical care was much higher in such highly competitive races than in the common ones.

並列關鍵字

Emergency medical services ； Mini-Eco challenge