摘要
Objective@#Helicopter emergency medical services (HEMS) have been used for prompt and appropriate transport of trauma patients. South Korea operates a dual HEMS system consisting of the Doctor-HEMS and the EMS-HEMS. This study compared the relevance of evaluation and treatment during transport using the two HEMS systems. @*Methods@#This was a retrospective, single-center cohort study, and 180 trauma patients transported via HEMS from July 2013 to June 2021 were enrolled in the analysis. We compared the appropriateness of evaluation and management between the Doctor-HEMS and the EMS-HEMS using a newly developed checklist based on Advanced Trauma Life Support protocol. @*Results@#In terms of the performance score, the EMS-HEMS was higher with respect to basic management at the scene, especially cervical immobilization and warming (P<0.001). On the other hand, the Doctor-HEMS showed a higher score with respect to monitoring and procedures during transport (P<0.001). The total performance score was higher in the Doctor-HEMS group than in the EMS-HEMS group (P=0.022). @*Conclusion@#The Doctor-HEMS generally showed better performance in the transport of trauma patients, although it showed relatively lower performance with respect to basic care at the scene. The EMS-HEMS displayed a lower performance in monitoring and management during air transport. It is necessary to develop a common checklist for both the Doctor-HEMS and the EMS-HEMS. Through continuous efforts and feedback, the transportation of trauma patients can be improved.
摘要
Thirty nine strains and 109 strains of Shigella sonnei were isolated from the outbreaks of Youngchun and Kyungju, respectively, while 15 strains were isolated from sporadic cases of eight regions in Kyungbuk province from September to November in 1998. We investigated the relationship among the S. sonnei strains by using biochemical characteristics, biotyping, antibiotic resistance pattern, and plasmid profile. Among the isolates, seven strains of S. sonnei isolated in Youngchun showed gelatin hydrolyase positive but the others showed gelatin hydrolyase negative. One hundred and fifty two strains were a type, while eleven among thirty nine strains isolated in Youngchun were g type. Antibiotics resistance patterns of S. sonnei strains isolated in Youngchun and Kyungju were significantly different. Thirty nine strains of S. sonnei isolated in Youngchun were resistant to SM, TE, and TMP/SMX, while eighty six of S. sonnei among one hundred and nine strains isolated in Kyungju were resistant to AM, CB, K, SM, TE, and TMP/SMX. Antibiotics resistance patterns of residual twenty three isolates were similar to those of eighty six strains. The Plasmid profiles of strains of S. sonnei isolated from the Kyungju were different from those of S. sonnei strains isolated in Youngchun. The Plasmid profiles of S. sonnei strains isolated from Youngchun were identical to those of a S. sonnei strains randomly selected from the outbreak in Daegu in 1998. The Plasmid profiles of S. sonnei strains isolated from Kyungju were identical to those of two strains of S. sonnei randomly selected from the outbreaks of Kanglung and Wonju in 1998. From the above results, it is considered that the strains of S. sonnei isolated from Kyungju and Youngchun region are not identical clone.