ABSTRACT
Objective:To investigate the relevant situation of the emergency departments (ED) of general hospitals at all levels in Zhejiang Province participating in the prevention and control of Corona Virus Disease 2019 (COVID-19), and to provide a reference for further improving the capacity of emergency services.Methods:A multi-center cross-sectional investigation study was jointly initiated by the Zhejiang Provincial Emergency Medicine Quality Control Center, the Emergency Medicine Branch of Zhejiang Medical Association, and the Emergency Physicians Branch of Zhejiang Medical Doctors Association. Before investigation, experts were organized to develop a special questionnaire. Then the ED of general people's hospitals or Chinese Medicine hospitals at the county/district-level or above were included and their participations in the prevention and control of COVID-19 epidemic between March 9, 2020 and March 15, 2020 were investigated. The collected information included: basic information of the hospitals; participation of ED in fever clinics; the number of COVID-19 patients admitted to ED; the situation of ED support to the anti-epidemic front-line; and the epidemic prevention facilities of ED, and the early supply of medical protective equipments.Results:A total of 181 hospitals from 11 prefectures and cities across the province were finally included, including 52 (28.7%) Grade-A tertiary hospitals, 45 (24.9%) Grade-B tertiary hospitals, 64(35.4%) Grade-A secondary hospitals, and 20 (11.0%) Grade-B secondary or lower hospitals. Among them, 93 (51.4%) were COVID-19 designated hospitals, and 49 (27.1%) had the ability to detect COVID-19 nucleic acid; 177 (97.8%) set up independent fever clinics and 33 (18.6%) were managed by ED alone or mainly. The medical staffs of 65 (36.7%) fever clinics were all or mainly from ED. A total of 213 cases of COVID-19 were received/treated in 40.3% ED, accounting for 17.3% of the total number of cases in Zhejiang Province. A total of 3 848 doctors and nurses supported the front-line of epidemic prevention, of them, 253 supported Hubei Province (accounting for 12.5% ??of the total number). There were 68.5% and 76.8% ED having spare separate clinic and ordinary rescue single room to deal with the COVID-19. In addition, at the early days of anti-epidemic, more than 50% ED were in short supply or even had no medical protective equipment.Conclusions:The ED of Zhejiang Province plays an important role and has made a great contribution to the prevention and control of the COVID-19 epidemic. It is necessary to improve the conditions of ED to effectively respond to the prevention and control of daily infectious diseases.
ABSTRACT
Objective To explore the curative effect of breathing machine in the treatment of acute heart failure complicated with respiratory failure.Methods 1 1 0 patients with acute heart failure and respiratory failure in emergency ICU of our hospital were selected,they were randomly divided into control group and observation group.The control group received routine therapy,the observation group was given breathing machine on the basis of routine therapy.The treatment efficacy of the two groups was compared.Results Before treatment,PaO2 ,PaCO2 ,PH and SaO2 between the two groups had no obvious differences (P >0.05 ).After treatment,PaO2 ,PH and SaO2 in the observation group were (1 1 .41 ±2.25)kPa,(7.42 ±0.1 9),(97.1 1 ±2.1 7)%,which were significantly higher than those in the control group,PaCO2 was (5.21 ±0.22)kPa,which was significantly lower than the that of the control group,the differences were statistically significant (t =2.501 ,P =0.01 4;t =2.598,P =0.01 1 ;t =2.855,P =0.005;t =-2.691 ,P =0.008).The level of sernm brain natriuretie peptide of the observation group[(472.32 ± 298.06)pg/L]was significantly lower than that of the control group,the difference was statistically significant(t =-2.263,P <0.05).Conclusion The clinical effect of breathing machine EICU in treatment of acute heart failure complicated with respiratory failure is remarkable,and can effectively improve the clinical symptoms,and is worth further clinical application.
ABSTRACT
Currently,the medical technology and service capability in grass-root medical institutions are still at low level.This article emphasizes the need for pilot bases of appropriate medical emergency technologies,introducing our experiences in this respect and the effects.We hope to offer reference for the promotion of appropriate medical emergency technologies.