救护车转移及其作为ED过度拥挤缓解策略的使用:它有效吗? 一个范围审查审查
Jin Han Malcolm Ong1, Bernard J W Lim2, Muhammad Ariffin B M Zahrin3
1Acute & Emergency Care Department, Khoo Teck Puat Hospital, Singapore, Singapore. malcolmong89@gmail.com.
International journal of emergency medicine
|July 8, 2025
概括
在急诊室 (ED) 过度拥挤期间,救护车转移 (AD) 对紧急医疗服务 (EMS) 和患者产生了不同的结果. 然而,转移厌恶措施显示出积极的趋势,表明需要对AD影响和定性影响进行更多研究.
科学领域:
- 紧急医疗 紧急医疗
- 医疗保健管理的管理
- 公共卫生 公共卫生
背景情况:
- 紧急诊所 (ED) 过度拥挤是一个具有严重影响的全球性挑战,包括增加患者死亡率.
- 救护车转移 (AD) 是一种缓解ED过度拥挤的策略,但它对紧急医疗服务 (EMS) 和患者护理的影响仍在争论中.
- 缺乏实施AD的操作指导进一步使其使用变得复杂.
研究的目的:
- 进行对同行评审的关于AD和转移厌恶措施影响的文献进行范围审查.
- 组织与EMS和患者结果相关的发现.
- 识别有关AD运营和定性影响的文献上的差距.
主要方法:
- 在多个数据库 (Medline,Embase,CINAHL,Psychinfo,Cochrane,ClinicalTrials.gov) 和在线门户 (ACEP,NAEMSP) 中进行系统的搜索.
- 包括报告EMS或与AD相关的患者结局在过度拥挤的ED中,包括转移厌恶干预的研究.
- 由两个独立审稿人进行选,对不同意见达成共识.
主要成果:
- 在10,061个记录中,包括95项研究,包括观察性,模拟性,干预性,描述性,系统性审查和混合方法研究.
- 大多数研究报告了EMS (12对2) 和患者 (19对9) 的负面结果.
- 减少转移的干预措施显示出积极的结果,有34篇文章支持转移厌恶.
结论:
- 关于阿尔茨海默病对EMS和患者结局的影响的确证据仍然有限,报告的消极结果比中性/积极结果更多 (31对11).
- 转移回避措施显示了整体的积极趋势,表明它们的潜在益处.
- 需要使用标准化标准进行进一步的研究来澄清AD的影响,包括对工作人员和患者的心理影响在内的定性结果需要更多的研究.
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