ドクターヘリ出動により初期治療を早期に開始し得た重症多発外傷の一例

There was a hotline that a 79-year-old man crashed from a height of 3m. The helicopter emergency medical service （HEMS） dispatched immediately. Flight doctors were in contact with the patient 14 minutes after hotline, and performed tracheal intubation and intravenous ensure path in the field. They came back to our hospital 44 minutes later. Emergency left thoracotomy was performed because the patient experienced cardiac arrest, due to the heart compression caused by the anterior mediastinal hematoma. The patient returned to spontaneous circulation. However, the patient condition was unstable due to bleeding from concurrent right hemothorax. We performed clamshell thoracotomy to stop bleeding, but the patient died by blood loss.
Quick start of the primary care is very important to the improvement of the survival rate in severe trauma cases. Our hospital introduced HEMS last year, and had been able to improve the quickness in response by promoting cooperation of ER trauma team and operation room. With this system, we could provide primary care and transportation for the patient before he went into the cardiac arrest. Further evaluation of this system would improve the survival rate in the severe trauma cases.