农村聚会:多次EMS转移如何影响创伤结果
1Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, WI, United States of America.
The American journal of emergency medicine
|June 8, 2025
概括
在农村地区的医院前EMS约会增加了创伤患者的临床衰退,更高的敏度和死亡率的风险. 改善创伤护理准入和运输协调至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 医院前护理 医院前护理
背景情况:
- 农村紧急医疗服务 (EMS) 往往依赖于医院前的约会,因为直接资源有限.
- 这种做法涉及EMS人员对患者运输决策做出独立判断.
研究的目的:
- 评估医院前约会对农村创伤患者治疗结果的影响.
- 评估对临床衰退,患者敏度和死亡率在到达急诊室 (ED) 时的影响.
主要方法:
- 一个单一中心的创伤登记研究分析了2000年1月1日至2023年12月31日的数据.
- 包括 11,937 个创伤患者,根据 EMS 约会地点的数量对其进行分类.
- 使用回归模型来评估ED倾向 (ICU/尸体),格拉斯哥昏迷量表 (GCS) 和冲击指数比率 (SIR) 等结果,控制患者和受伤因素.
主要成果:
- 几乎一半 (49%) 的患者至少经历过一次约会.
- 一次或两次约会的患者显示,ICU或尸体处置的几率明显更高.
- 增加的约会时间与较低的GCS分数和更高的冲击指数比率 (SIR) 在抵达时相关 (p < .01).
结论:
- 创伤护理的医院前约会与临床衰退的增加,更高的敏度和更高的ED死亡率有关.
- 这些发现强调了提高获得终极创伤护理的必要性.
- 强调在区域创伤系统中协调运输的重要性.
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