COVID-19 hastalarının hava ambulansı ile nakli

Amaç: Yeni koronavirüs hastalığı (COVID-19) pandemisinde, acil sağlık hizmetleri kara ve hava ambulanslarıyla ön hatta görev almakta ve ciddi zorluklarla karşılaşmaktadır. COVID-19 hastalarının bakımı ve Avrupa çapında hava ambulans sistemleri ile taşınmasına ilişkin veriler çok sınırlıdır. Pandemi döneminde yurt içi ve yurt dışı birçok COVID-19 hastasının transferi hava ambulansları ile yapılmıştır. Bu çalışmada, hava ambulans sistemiyle taşınan COVID-19 hastalarının tanımlayıcı özelliklerinin incelenmesi amaçlanmıştır. Yöntem: Çalışmamız retrospektif bir kohort çalışmasıdır. Çalışmaya 15.04.2020-31.12.2020 tarihleri arasında RT-PCR testi sonucuna göre COVID-19 tanısı konulup sabit kanatlı hava ambulansı ile transfer edilen hastalar dahil edildi. Vakaların bilgileri Sağlık Bakanlığı Acil Sağlık Hizmetleri Otomasyon Sisteminden (ASOS) ve uçuş kayıtlarından elde edildi. Hastaların uçuş süresi, yaşı, cinsiyeti, yatış yeri (servis/yoğun bakım ünitesi), vital bulguları, aldıkları tedavi (nazal oksijen, non invaziv mekanik ventilasyon (NIMV), mekanik ventilasyon), taşınma şekilleri ve taşınma sonrası dezenfeksiyon işlemleri incelendi. Bulgular: Verilerimizin toplandığı sekiz buçuk aylık süre zarfında sabit kanatlı ambulans ile taşınan ve real time PCR testi sonucuna göre kesin COVID-19 tanısı konulan hasta sayısı 80 olmuştur. Hastaların %85’i erkek ve yaş ortalaması 44,7 ± 14,0 olarak bulunmuştur. Ortalama uçuş süresi 492,2 ± 270,8 dakikaydı. Transfer edilen COVID-19 hastalarının %87,5’i (n=70) yataklı servise, %12,5’i (n=10) yoğun bakım ünitesine yatırılmıştır. Transfer sürecinde %2,5’i (n=2) CPAP (Devamlı Pozitif Havayolu Basıncı) tedavisi, %3,8’i (n=3) mekanik ventilatör takibi, %22,5’i (n=18) intravenöz (İV) sıvı tedavisi ve %71,3’ü (n=57) nazal oksijen tedavisi almıştır. Tüm hastaların transferinde tıbbi ekip kişisel koruyucu donanım (KKD) kullanmıştır. Hastaların %97,5’i (n=75) portabl izolasyon ünitesi (PÜ)’nde, %2,5’i (n=5) ise izolasyonsuz transfer edilmiştir. Sonuç: COVID-19 hastalarının havayolu ile nakli ve bakımları, uçuş süresi uzun olsa bile uygun görülmektedir. KKD’nin uygun kullanımı ve COVID-19 hastalarının PÜ’ler içinde havayolu ile taşınması görevli personel için güvenli olabilir.

Transport of COVID-19 patients by air ambulance

Objective: In the new coronavirus disease (COVID-19) pandemic, emergency healthcare services work on the frontline with land and air ambulances and face serious challenges. Data on the care of COVID-19 patients and transport by European air ambulance systems are very limited. During the pandemic period, many domestic and international COVID-19 patients were transferred by air ambulances. In this study, we aimed to reveal the analysis of COVID-19 patients transported by our air ambulance system and how the transfers took place. Methods: Our study is a retrospective cohort study. Patients who were diagnosed with COVID-19 as a result of RT-PCR and transferred by fixed wing air ambulance between 15.04.2020 and 31.12.2020 were included in the study. The information of the cases was obtained from the Ministry of Health Emergency Health Services Automation System (ASOS) and flight records. Flight time, age, gender, hospitalization status (ward / intensive care unit), vital signs, treatment received (nasal oxygen, non-invasive mechanical ventilation (NIMV), mechanical ventilation), transportation patterns and post-transport disinfection procedures were recorded. diagnosis of COVID-19 according to real time PCR results with fixed wing ambulance was 80. 85% of the patients were male and the mean age was 44.7 ± 14.0 years. The average flight time for these patients was 492.2 ± 270.8 minutes. 87.5% (n = 70) of the COVID-19 patients were hospitalized in the inpatient service and 12.5% (n = 10) in the intensive care unit. 2.5% (n = 2) CPAP (Continuous Positive Airway Pressure) therapy, 3.8% (n = 3) mechanical ventilator follow-up, 22.5% (n = 18) intravenous (IV) fluid therapy and 71.3% (n = 57) received nasal oxygen therapy. Medical team used Personal Protective Equipment (PPE) in transferring all patients. 97.5% (n = 75) of the patients were transferred in the Portable Isolation Unit (PIU) and 2.5% (n = 5) were transferred without isolation. Conclusion: Transport and care of COVID-19 patients seem appropriate even for long periods from the air. Proper use of PPE and PIUs can provide security for personnel in charge of air transport of COVID-19 patients.

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