低收入和中等收入国家的紧急情况负担
Peter G Delaney1, Zachary J Eisner2, Heike Geduld3
1Cleveland Clinic, Cleveland, OH.
Surgery
|May 18, 2024
概括
伤害造成了全球显著的死亡率,特别是在低收入国家. 世界卫生组织现在建议以社区为基础的Tier 1紧急医疗服务作为医院前护理发展的关键第一步.
科学领域:
- 全球健康 全球健康
- 创伤外科 手术 创伤外科
- 公共卫生政策 公共卫生政策
背景情况:
- 伤害是全球主要的外科手术疾病负担之一,导致全球10%的死亡.
- 道路交通伤害是年轻成年人 (5-29岁) 死亡的主要原因,不成比例地影响低收入和中等收入国家 (LMICs).
- 在LMICs中现有的创伤系统不足以可持续地管理医院前伤害负担.
研究的目的:
- 突出在LMICs有效的医院前紧急医疗服务 (EMS) 的关键需求.
- 引入一个框架,在资源有限的环境中开发可持续的EMS.
- 根据全球前医院联盟的建议,概述未来EMS发展的优先领域.
主要方法:
- 该研究回顾了全球伤害统计和死亡率数据.
- 它分析了在LMIC中复制高收入国家EMS模型 (二级) 的局限性.
- 它介绍了世界卫生组织对Tier 1 (旁观者驱动) 医院前护理的建议,以及全球医院前协会 (Global Prehospital Consortium) 关于EMS发展的7个优先领域.
主要成果:
- 在LMICs,正式的二级EMS系统在很大程度上失败了.
- 推使用非专业的急救人员的Tier 1系统作为初步方法.
- 全球前医院联盟确定了EMS发展的7个关键领域:基础设施,通信,教育,评估,融资,治理和运输.
结论:
- 迫切需要在LMICs开发强大的,经济可持续的医院前创伤系统.
- 一级EMS是改善这些地区医院前护理的可行起点.
- 针对7个优先领域的结构化,多方面的方法对于全球成功的EMS发展至关重要.
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