創傷性到院前心臟停止：102個案例分析

Traumatic Out-of-Hospital Cardiac Arrest An Analysis of 102 Cases

鄧允武(Yun-Wu Deng) ； 洪國泰(Kuo-Tal Hung) ； 張玉龍(Yu-Lung Chang) ； 藍秉文(Ping-Man Lam)

《台灣急診專科醫師期刊》 5卷2期 (2013/06) Pp. 23-27

摘要

目的：了解創傷性到院前心臟停止病患的各種面向。方法：回溯性檢視病歷。結果：102例中男性佔80.4%，平均年齡為40.0歲；以119救護車到院的佔94.1%，創傷機轉以機車意外最多(38.2%)，60.8% 有頭部創傷；76.5% 屬於未目擊的心臟停止，初始心律為Asystole的佔80.4 %，有22.5%病人回復自發性循環；緊急救護反應時間平均5.8分鐘，現場處置時間平均9.1分鐘，緊急救護轉送時間平均8.6分鐘，平均急救時間17.2 分鐘，存活率1.0%。結論：創傷性到院前心臟停止病患有高死亡率，預後很差。

關鍵字

到院前心臟停止 ； 創傷

並列摘要

Objective: To investigate the demographic characteristics, injury patterns, resuscitative process, and prognosis at patients with traumatic out-at-hospital cardiac arrest (OHCA). Method: Retrospective review of medical records at a district hospital trauma center between January and December, 2009. Results: at the 102 patients, 80.4% were males. The mean age was 40.0 years. The arrival method was fire department ambulance in 94.1% at cases, and 76.5% at cases were not witnessed. The most common traumatic mechanism, motorcycle accidents, occurred in 38.2% of cases. The most common initial rhythm was asystole in 80.4%. Trauma to the head occurred in 60.8% of patients. The average emergency medical services response time was 5.8 minutes, the average time on the scene was 9.1 minutes and the average transport time was 8.6 minutes. Alcohol was detected in 35.8% of patients who had traffic accidents. The mean alcohol concentration was 166.1 mg/d l. The rate of return of spontaneous circulation was 22.5%, and the mean resuscitation time was 17.2 minutes. The admission rate was 11.8%. The mean length of hospitalization was 5.1 days. The survival rate was 1.0%. Conclusion: Patients who had trauma and OHCA had a high mortality rate and poor outcomes.

並列關鍵字

out-at-hospital cardiac arrest ； trauma