[Monitoring critically ill patients during transport by helicopter using a patient with abdomen apertum as an example].
Noninvasive continuous monitoring systems are newly emerging as an important means of monitoring during transports in emergency care, e.g. transportation by helicopter. While automatic oscillometric blood pressure monitors have been used in the perioperative area for some time, a similar development can be observed in the field of emergency care and transportation with the availability of light, portable and battery operated systems. For monitoring adequate oxygenation, pulse oximeters have recently been brought into discussion for both the perioperative period and the transport of critically ill patients. In contrast to well-established monitoring techniques during helicopter transports (ECG, inspection, manually measured blood pressure (BP), pulse oximetry reveals an oxygen deficiency due to respiratory and cardiocirculatory problems, enabling precious time to be saved. This concept is illustrated during the helicopter transport of a critically ill patient with abdomen apertum caused by Clostridium perfringens infection. Even with a critical look at the already described mishaps of this method--e.g. overestimation of true O2 saturation (sO2) and additional overestimation caused by Hb-derivatives--pulse oximetry was found to be superior to the established monitoring techniques. Furthermore, oscillometric blood pressure detection was very satisfactory during the 30-min helicopter transport. Based on our results, we believe pulse oximetry and automatic oscillometric BP-measurement to be useful for monitoring during transports in helicopters, thus improving patient safety.
Mertzlufft
F O
FO
Klinik für Anaesthesiologie, Johannes Gutenberg-Universität, Mainz.
Heinrichs
W
W
Brost
F R
FR
Dick
W
W
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000401:Aircraft; D001795:Blood Pressure Determination / Q000295:instrumentation; D005260:Female; D005738:Gas Gangrene; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D010092:Oximetry; D013530:Surgical Wound Infection; D014187:Transportation of Patients
Die Uberwachung Schwerstkranker während des Hubschraubertransportes am Beispiel einer Patientin mit Abdomen apertum.