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Japanese

Timing of Helicopter Transportation for Patients Presenting with Subarachnoid Hemorrhage on Isolated Islands Ichiro KAWAHARA 1 , Yuki MATSUNAGA 1 , Keisuke TSUTSUMI 1 , Hideaki TAKAHATA 1 , Tomonori ONO 1 , Keisuke TODA 1 , Hiroshi BABA 1 1Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center Keyword: helicopter transportation , isolated islands , re-rupture , subarachnoid hemorrhage pp.537-543
Published Date 2014/6/10
DOI https://doi.org/10.11477/mf.1436102262
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 Cerebral aneurysm re-rupture following subarachnoid hemorrhage(SAH)is a serious problem that is related with poor outcome. It is generally said that re-rupture occurs within 6 hours of the initial SAH;in the acute stage, strict management is needed even in the period before hospitalization. The aim of this study was to confirm whether patients on isolated islands should be transferred by helicopter > 6 hours after the initial SAH. Here we reviewed 125 cases of SAH in the isolated islands of Nagasaki prefecture between January 2007 and December 2012 who were transferred to Nagasaki Medical Center by helicopter as a result of consultation via TeleStroke(41 men, 84 women;mean age, 65.76 years). Re-rupture was observed in seven patients(5.6%), five of whom were diagnosed with re-rupture in a prior hospital on the isolated island. No patients demonstrated clinical deterioration during transport.

 Early helicopter transportation under adequate sedation and control of blood pressure within 6 hours is safe, and patients should be transferred as quickly as possible during the day. On the other hand, at night, flight safety must first be considered. Patients in stable clinical condition may be transferred the next day. We should pay special attention to patients with SAH and intracerebral hemorrhage, severe SAH, or vertebral artery dissecting aneurysm because their condition may gradually become more serious even if initially stable.


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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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