日本救急医学会雑誌
Online ISSN : 1883-3772
Print ISSN : 0915-924X
ISSN-L : 0915-924X
迅速なヘリコプター搬送が有効であった腹部大動脈瘤破裂の1例
本間 正人大友 康裕井上 潤一加藤 宏原口 義座辺見 弘
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1999 年 10 巻 7 号 p. 415-420

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We examined a case of rapid helicopter transportation, which was crucial to the survival of a ruptured abdominal aortic aneurysm (AAA) patient with profound shock. A 70-year-old woman, who presented at home with acute severe back pain, was transferred by helicopter 50km to our hospital. On arrival, she had no detectable blood pressure and soon developed bradycardia with subsequent cardiac arrest, which required an emergency room thoracotomy Å @ (ERT). After open cardiac massage and thoracic aortic cross-clamping, her heart beat was recovered. Additional laparotomy revealed about 500ml of blood from intraperitoneal bleeding and a large dilated and ruptured retroperitoneal hematoma. The AAA was reconstructed using a Y-graft. On the 78 hospital day, she was discharged from our hospital without any neurological defects. In this case, all factors such as the intimate cooperation between the ambulance EMTs and aviation team, early call and prompt dispatch of the helicopter, and effective therapy by the receiving hospital were necessary for the survival of this patient. We concluded that we should promptly prepare an emergency helicopter system for improving the outcome of patients in local areas, and that these systems will prove effective in case of natural or civil disaster.

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