Air Medical Interventions at Comatose Pediatric Patients in Eastern Romania - Particularities of Airway Managementand Cardio-Pulmonary Resuscitation

Abstract

Pediatric comas are particular situations of terrestrial or aerial medical intervention, requiring knowledge of specific protocols and prioritization and hierarchy of emergency interventions. The reactivity of the comatose child is modified according to multiple biological, physiological parameters and generating pathologies. The study aims to analyze the specific elements of aerial medical interventions with helicopter, HEMS (Helicopter Emergency Medical Service) at comatose child that influences the emergency path, but especially the medium and long term prognosis of these cases. The transfer of comatose children at Galati aeromedical base, both primary and secondary interventions, were studied. The study was a prospective randomized study involving pediatric comas transferred over a 4-year course (2014-2017) according to the criteria in force. A total of 24 children between the ages of 0-18 years were transferred, with primary and secondary interventions. In the study lot, the correlations between Glasgow scores and associated pathology, epidemiological characteristics, therapeutic elements, complications and case evolution were analyzed. A profile of the patient requiring emergency intervention for the comatose state was created, making it possible to predict the services they will need and to design the specialized interventions that will follow the transfer of these patients. Although still intensely disputed due to cost considerations, the air transfer of the comatose child facilitates a more prompt response of medical systems to manage this type of emergency and presents management particularities in pre-hospital. Based on this type of results, a strategy takes shape by which the Romanian emergency system aligns with the continuous improvement of life-saving interventions for children.