病例识别变化对澳大利亚直升机急救医疗服务中医院前输管性能指标的影响
Alan A Garner1,2,3, Andrew Scognamiglio4, Sviatlana Kamarova5,6
1Nepean Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Emergency medicine Australasia : EMA
|October 2, 2024
概括
直接直升机紧急医疗服务 (HEMS) 查改善了创伤患者的输管时间,79%的人达到45分钟的基准,而在中央控制下为43%. 这凸显了调度系统对重症监护服务的影响.
科学领域:
- 紧急医疗 紧急医疗
- 创伤护理 创伤护理
- 医院前服务 医院前服务
背景情况:
- 从受伤到输管的45分钟间隔是严重创伤管理的关键绩效指标.
- 之前在悉尼医院前系统中对病例识别系统的更改与激活延迟有关.
研究的目的:
- 评估调度系统的变化是否影响了在45分钟的基准时间内输管严重创伤患者的比例.
- 为了比较直接的HEMS机组人员查和中央控制室调度之间的输管时间.
主要方法:
- 追溯队列研究分析了两段时间的直升机紧急医疗服务 (HEMS) 输管.
- 第1期:HEMS机组人员直接检查了计算机化调度系统.
- 第2期:医护人员在中央控制室处理调度.
主要成果:
- 在HEMS船员查期间,79.31%的输内管达到45分钟的目标,而在中央对照期间为43.6% (P < 0.001).
- 与中央控制 (47 分钟) 相比,HEMS 机组人员查 (33 分钟) 的中位时间到输管时间显著缩短 (P < 0.001).
- 多变量分析确定了调度系统,现场距离,陷和输管指示作为影响输管时间的重要因素.
结论:
- 直接的HEMS机组人员查显著减少了从紧急呼叫到输管的时间.
- 在HEMS查期间,在50公里范围内所有未被困的患者在45分钟内被直管.
- 中央控制系统的调度延迟阻止了对非被困患者及时输管的保证,无论距离如何.
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