RESUMEN
Considering the limited available resources, high cost of the helicopter emergency medical service [HEMS], and high load of trauma patients especially in our centers, a careful assessment of HEMS in our center seemed to be necessary for trauma patients. From April 2001 to September 2007, the data of all patients transferred by HEMS were extracted including: Annual number of services, clinical category, number of proper or improper services, and rescue time for HEMS and ground ambulance. The criteria for the properly transferred group included: Death or being operated in the first 24 hours of admission, admission in ICU care units, and transfer of more than three patients in one mission. Others were considered as improper group. In this period through 185 flights, 225 victims were transferred. The most common reason of HEMS dispatching was trauma. The most difference of rescue time between ground ambulance and HEMS was recorded in Lamerd that was transferring patients with HEMS needed 3 hours less than ground ambulance. However, in Sarvestan, Dashte-Arjan, and Marvdasht, transferred patients with ground ambulance needed less time than air transfer. Most of transferred patients were from Kazeroon, Nourabad and Lamerd respec-tively while 46.3% of patients were in the proper group, and the rest were considered as improper group. Our study revealed that helicopter dispatch to the cities like Lamerd, Lar, Khonj, Abadeh can be more effective, whereas, for the towns like Marvdasht, Dashte-Arjan, Sarvestan, Sepidan, Saadatshar, Tang Abolhayat use of HEMS should be limited to specific conditions. Our study showed inclusion of physicians in the decision making team increased the number of transferred cases
RESUMEN
The Cuff of the endotracheal tube is securing for Mechanical Ventilation during anesthesia. Diffusion of N2O into the Cuff results in an increase in Cuff pressure. The different method was used for the control of Cuff pressure, but may have difficulty and side effect. This study was to determine whether inflating the ETT Cuff with Air, Lidocain 1% or N[2]O with O[2], prevent the increase in Cuff pressure during N[2]O nesthesia. In this randomized control trial study after obtating ethics committee 224 patients went understudy, these patients divided in two bloks [Sufe, Roach] and the one of the each blok were randomized into three groups. Group, air lidocaine 1% N[2]O with O[2] difficult intubation and the film anesthesia with less than 30-min were excluded. All patients were similarly anesthetized and performed tracheal intubation. The pilot balloon of the endotracheal tube Cuff was connected to a Japanese pressure manometer. The first pressure was measured immediately and further reading at 10-minute intervals for 70 minutes. The results were readings analysed using T- test, paired t test, Anova and the Chisquare test. A P-value of <0.05 was considered significant. Cuff pressure increased gradually during anesthesia in-group air but remained stable in group's lidocaine and N[2]O with O[2]. The Cuff pressure had significant differences between the supa and Roach groups in all of the times during anesthesia [P<0.05]. Inflating the ETT Cuff with lidocaine 1% or N[2]O/ oxygen mixtures are methods of keeping intracuff pressure stable during N[2]O anesthesia due to N[2]O diffusion the Cuff tube causes increase the Cuff pressure. We suggest that continuous monitoring of the UCP during anesthesia to be carried out