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Hidalgo Transport des patients en France .pdf



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Hidalgo Transport des patients en France

A 32-year-old patient who ejects from his motorcycle at 100km / hr, the
patient was not wearing a helmet and receives frontal trauma with
sagging of the bone and loss of consciousness, 40min later you arrive on
the scene and start driving, Would move What physiological conditions
would you consider in order to transfer it? Why trauma kinematics
would you suspect?
In many of the Spanish-speaking countries where Prehospital
Emergency services are not well developed and equipped as such, they
have the theory that an ambulance is a "means of transportation more"
leading to comparison with a "Taxi" but they do not have in That
depending on the pathology of the patient must also have minimum
safety conditions to not alter the physiological and basic
pathophysiological state that the patient presents at that moment, it is not
the same with a patient with a heart attack, a pregnant woman or A
patient with increased intracranial pressure, this is why in this paper we

will try to disclose the factors that alter the clinical condition of the
critical patient and what to do to minimize this, I am sure it is a very
important issue and I have given Many do NOT know and are shocked
to see how the sound of the siren or vibration causes more damage to
that patient with heart attack they are attending and moving, there is very
little literature that can be found about this, but I know this Will help
many to become aware and from now on keep it in mind for their next
patients. Some of the history and where the idea of creating this means
of transportation for the injured came up.
These are some important dates for the history of the emergency
systems:
 1862 Jhon Letterman Improves the system with an ambulance,
with a sergeant on horseback and 2 stretchers inside the carriage.
 1862 Progress Important in the fixation of the femoral fractures
reduces mortality in the transference by 70%.
 1867 Jean Henry Dunant Creates the Red Cross
 1870 The aerial medium is used for the first time
 1910 First tests of transfer in airplane in France, after 800 meters
the plane falls.
 1944 During the Second World War, ambulance systems
improved.
 1951 Korean War helicopters are used to evacuate the wounded of
the site
 1959 World interest countries like France USSR, Germany and
Italy begin to structure their systems of Pre-hospital care SAMU
France.

After knowing something about the evolution of ambulances and
prehospital services we get into the subject and we will know what are
the physical factors that generate physiological changes in the patient:








Acceleration and Deceleration.
Noise.
Temperature.
Vibrations
Gravity.
Turbulence.
Heights

Let's touch the points that are highlighted as we will talk about critical
patient transportation terrestrial. (Keep in mind that these factors not
only alter the patient, they also alter the medical equipment and its
results)

Acceleration-Deceleration
The speed changes during the transfer of the patient both increase and
decrease speed cause physiological changes in the body that determine a
response, is the development of inertial forces proportional to the mass
of the body, these changes in speed cause displacement of liquids And
masses within the organism. These movements are captured by organic
receptors (Proprioceptives, Baroreceptors, Receptors of the labyrinth)
provoking responses ranging from alterations in intracranial pressure,
hypotension, hypertension, tachycardia, bradycardia, to general malaise
and vague pictures.

Vibrations
It can be transformed into; Mechanical Energy, Caloric Energy,
Pressure. Vibration is an alternating and repetitive form of movement. It
constitutes a form of energy transmissible to the human being that can
be cause of adverse effects and even become dangerous to high
frequencies (14-18Hz).

Noise
The source of noise and its intensity level will vary depending on many
factors, the siren is the main source of noise although also must take into
account the traffic, electromedical material and the own noise of the
vehicle, the sirens of the ambulances are between 70 - 80 dBA the
allowed limit is 85 dBA.

Temperature
Hypothermia and hyperthermia cause physiological changes in the body.
Hypothermia, which is particularly sensitive to the traumatized patient
exposed to ambient air, may cause chills to vascular collapse.
Hyperthermia causes peripheral vasodilation and metabolic alterations
due to increased sweating.
In conclusion we must give our patients the best care and care and think
that these factors affect whether or if basic pathology, we must take
these points into account to avoid these physiological alterations
previously named:





Prepare the patient for the transfer in the best conditions.
Drive avoiding sudden accelerations and decelerations
Securely attach to the stretcher and loose equipment that may fall.
Check the temperature of the cubicle.

 Use thermal blankets
 The vehicle must be in good mechanical condition (suspension,
damping, etc.)
 Know the pathology of your patient and the changes that the
movement-vibration-temperature-noise can cause in them.

Sources
 Critical care transport of patients who have acute neurological
emergencies
 Patient Transport Critical
 Transfer of critical patients: secondary and primary transport
protocol


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