ObjectiveTo investigate the significance of professional pre-hospital rescue and the effect of hospital treatment on the physical and mental health for extensively gas explosion injured patients. MethodsEarly pre-hospital management and hospital treatment were both implemented for 28 injured patients in extensively gas explosion between January 2003 and May 2013. ResultsAll the 28 patients underwent strict early management and hospital treatment, including telephone reception, condition judgment, first aid, and hospital treatment. One patient died before being hospitalized, and others patients were cured and discharged from the hospital. ConclusionIt is effective to implement timely, standardized pre-hospital care in reducing mortality and it is important to implement comprehensive treatment for patients to recover their physical and mental health.
目的:探讨使用院前指数(Prehospital Index, PHI)及格拉斯哥昏迷评分(Glasgow Coma Score, GCS)两种创伤评分法对院前急救中急性酒精中毒合并外伤性颅内出血患者的评估价值。方法: 纳入68例院前急救中酒精中毒合并头外伤患者,院前均进行PHI及GCS两种创伤评分,随访至出院,以头部CT扫描及随访结果作为标准以判断患者是否伴有颅内出血。计算两种创伤评分的敏感度、特异度、阳性似然比、阴性似然比、阳性预测值、阴性预测值及Youden指数,并作出受试者工作特征曲线(ROC曲线),以正态离差值Z检验两种评分法ROC曲线下面积的差异。 结果: 院前指数以6分作为诊断界值,敏感度为94.7%,特异度为71.4%;格拉斯哥昏迷评分以9分作为诊断界值,敏感度为98.8%,特异度为30.6%,PHI及GCS的ROC曲线下面积分别是0.881和0.678,其差异有统计学意义。结论: 在对急性酒精中毒合并头外伤患者是否伴有颅内出血的院前评估中,院前指数较格拉斯哥昏迷评分更有价值。
目的 研究汶川地震后精神伤害对院前急救的影响。 方法 对2010年10月1日－2012年10月31日院前急救患者的地震后家庭成员状况、精神伤害情况及病情程度进行回顾性病例对照分析。共有446例患者纳入研究，男278例，女188例；年龄（41.4 ± 2.8）岁。依据家庭成员遇难状况分3组，A组（家庭成员在地震中遇难）25例，B组（家庭成员在地震中受伤，无遇难情况）127例，C组（地震家庭成员完好）314例。 结果 各组患者最常见的精神伤害状况是焦虑（A组96.0%，B组71.7%，C组40.8%）、过度警惕（A组92.0%，B组70.9%，C组50.0%），差异有统计学意义（P＜0.001）。A组患者要求到上级医院继续治疗率较高（A组56.0%，B组39.4%，C组8.9%），组间差异有统计学意义（P＜0.001）。 结论 地震给人们的精神创伤较重，至今仍然普遍存在，并对患者的就医活动产生影响。提示在北川县院前急救工作中需要考虑患者的精神伤害情况。
目的 调查在院前急救中医患双方对留置针使用的满意度，并就留置针在急救中应用的合理性进行研究。 方法 将我院急诊科2011年6月－8月院前急救的患者，按出诊顺序分为两组，观察组患者使用留置针穿刺建立静脉通道，对照组则采用一次性静脉输液针，并调查患者或亲属、穿刺操作护士就两种穿刺方法的满意度。 结果 观察组留置针一次穿刺成功者达198例（94.29%），对照组一次穿刺成功者为206例（88.79%），两组比较差异有统计学意义（P＜0.05）；护士对留置针使用满意度明显高于一次性静脉输液针；患者及家属对留置针在保持静脉通道通畅、输液肢体舒适的满意度较一次性静脉输液针高。 结论 静脉留置针在院前急救中能提高医患双方的满意度，值得推广使用。
ObjectiveTo investigate the epidemiological situation of pre-hospital emergency elderly and non-elderly patients in Chengdu and explore the characteristics of pre-hospital care in the city.MethodAll pre-hospital care records in the Chengdu 120 Emergency System Database in 2017 were retrospectively collected. According to the age of the patients, they were divided into the elderly group (≥60 years old) and the non-elderly group (<60 years old). The disease spectrum, the trends of the number of emergency help calls, the changes in different diseases over time, as well as the disease composition of the patients who died in the two groups were compared.ResultsA total of 179 387 pre-hospital emergency patients were enrolled, including 59 980 elderly patients and 119 407 non-elderly patients. Most of them were male patients in both groups. Patients in the elderly group were mainly between 60 to 89 years old, and the ones in the non-elderly group were mainly between 18 to 59 years old. The pre-hospital emergency patients in the elderly group presented with trauma, nervous system, symptoms and signs, and cardiovascular system diseases mainly, accounting for 29.19%, 14.64%, 13.82%, and 12.86%, respectively. In the non-elderly group, trauma, acute poisoning, and symptoms and signs were predominant, accounting for 50.89%, 10.98%, and 10.08%, respectively. Among the pre-hospital deaths, the number in the elderly group was the larger, accounting for 69.61% (7 043 cases); the mortality rate was 11.74%, with sudden death (28.70%), cardiovascular diseases (25.95%), and respiratory diseases (16.07%) being the major causes. The pre-hospital mortality rate of non-elderly patients was 2.58%, mainly including traumatic diseases (35.41%), sudden death (unknown cause of death) (25.33%), and cardiovascular diseases (17.56%). The number of emergency help calls in the elderly group began to increase gradually from September, reaching a peak in December and hitting the trough in February. While in the non-elderly group, the peak of the emergency help calls appeared in July, and it also fell to the lowest in February. The proportion of the number of emergency help calls in the elderly group was higher in January to February and October to December; while the peak in non-elderly group was in July. The number of emergency help calls in the elderly group were mainly concentrated in the daytime (08:00 to 20:00). In the non-elderly group, the changes in the number of emergency help calls were similar to that of the elderly, however, with another peak (20:00 to 24:00). The proportion of the number of emergency help calls in the elderly group was 06:00 to 09:59, and the peak time of the non-elderly group was in the early morning (00:00 to 04:59) and night (20:00 to 23:59).ConclusionsThe number of pre-hospital care for elderly and non-elderly patients has its own characteristics in terms of the time and the distribution of disease spectrum. Trauma and cardiovascular diseases are the most common causes of pre-hospital care and death in Chengdu. And the pre-hospital mortality in the elderly group is much larger than that in non-elderly group. Relevant departments can allocate emergency resources rationally, and focus on improving the on-site rescue capacity towards related diseases.
目的:通过分析2007年自贡市急救中心院前急救反应能力，探讨其影响制约因素及解决方法。方法：回顾性分析2007年1～12月份自贡市急救中心院前出诊的全部有效病例呼救时间、出车时间、到达现场时间及出诊距离，计算出车准备时间、车辆行驶速度、应急反应时间、急救半径。结果：全年院前出诊共3336例，出车准备时间（2.06±0.93） min，车辆平均行驶速度32.17 km/h，应急反应时间（12.51±10.87） min，急救半径（5.60±5.35） km。结论：我市急救中心目前取得一定成绩，需采取多种措施进一步提高急救反应能力。