Abstract
Purpose: In recent years, refusals of pregnant patients with severe complications and inadequate methods of transporting neonates have become problems in emergency medical care in Japan. We analyzed the use of the helicopter transportation system“Doctor Helicopter”for perinatal patients in Wakayama.
Materials and Methods: We studied Doctor Helicopter's use for emergency perinatal treatment and examined the causes of patients' disease, location of referring hospitals, average transportation time, expected time reduction compared to ambulance transportation, treatment given before and during transportation, changes in vital signs and oxygen administration during airlift, prognoses after hospitalization, and outcomes. Our study's subjects were 41 maternal patients and 43 neonates transported by helicopter to Wakayama Medical University Hospital (WMU) between 2004 and 2010. We examined 83 perinatal patients transported by ambulance and compared ambulance transportation to helicopter transportation. We requested the regression line and equation at the transportation distance and time. We assumed the significance level to be 5%.
Results: Patients transported via helicopter included 39 pregnant patients (95.1%) who almost delivered prematurely and 43 neonates (including 21 congenital cases). Most of the cases involved transportation from hospitals farther than 50 km from WMU. Doctor Helicopter's average speed was 171.1 km/hr and, compared to ambulance transportation, we can expect a time reduction by helicopter of 61 minutes over 50 km. As for changes in vital signs during airlift, we observed no change in heart rate or mean blood pressure, but we did note a decrease in SpO2 (p<0.05). One (2.4%) maternal patient and six (14.0%) newborns received oxygen administration during airlift. There were 33 (80.5%) deliveries and 15 (36.6%) Caesarean sections. Of the 33 babies delivered, 14 (42.4%) had an extremely low birth weight. All newborn patients were treated in the Neonatal Intensive Care Unit, and19 (44.2%) underwent an operation. The prognoses were: discharge, 29 (67.4%); transfer, 7 (16.3%); and death, 6 (13.9%).
Discussion: Doctor Helicopter can shorten the transportation time compared to an ambulance. Moreover, during transportation, circulatory dynamics were steadied against a decrease in SpO2 by appropriate oxygen administration.
Conclusion: Air transportation for maternal patients and neonates is speedy and safe, and results in early and adequate treatment. The Doctor Helicopter system is beneficial and helpful for perinatal medical care.
