在EMS非运输中的生命体征评估:国家分析
Alyssa Green1, Sheree Murphy1, Michael Redlener2
1National EMS Quality Alliance, Irving, Texas.
Prehospital emergency care
|July 17, 2025
概括
近一半的紧急医疗服务 (EMS) 非运输事件缺乏完整的生命体征评估. 需要有针对性的质量改进,特别是在摔倒后的老年人中,以提高患者的安全性.
科学领域:
- 紧急医疗服务研究 医疗服务研究
- 医疗保健服务研究 医疗服务研究
- 患者安全 患者安全
背景情况:
- 生命体征评估对于在紧急医疗服务 (EMS) 遭遇期间评估患者状况至关重要.
- 不完整的生命体征文档可能会影响患者的护理和安全,特别是在非运输的情况下.
研究的目的:
- 评估非运输EMS遭遇的完整生命体征文档的国家绩效.
- 识别患者,机构和事件特征与生命体征评估变化相关.
主要方法:
- 对2023年国家EMS信息系统 (NEMSIS) 公开发布研究数据集的回顾性分析.
- 包括因911事件导致不运输的成年患者,不包括到达前心脏骤停的患者.
- 一个完整的生命体征集的定义,包括心率,呼吸率,脉冲氧度,缩血压和意识水平.
主要成果:
- 只有54.6%的符合条件的非运输事故有完整的生命体征集记录;9.8%没有生命体征记录.
- 个人生命体征评估范围从70.9% (SpO2) 到86.0% (心率).
- 根据机构类型 (ALS:57.3%,BLS:44.7%,EMR:26.8%) 的表现有所不同,并受到现场时间,调度原因和患者人口统计学 (例如,跌倒后的老年人) 的影响.
结论:
- 很大一部分非运输EMS遭遇缺乏完整的生命体征评估,这表明EMS性能存在很大变化.
- 迫切需要质量改进举措来加强生命体征文档,特别是对于高风险人群,如老年人摔倒后.
- 改善生命体征评估对于患者安全和在医院前护理中有效的临床决策至关重要.
相关概念视频
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01:20Assessment of Ventilation I: Respiratory Rate
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01:17Assessment of Diffusion and Perfusion
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Apical-Radial (A-R) Pulse Assessment
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