ABSTRACT
Objective To explore the value of intelligent early warning system in pre- and in-hospital connection in the treatment of stroke. Methods The clinical data of the patients with suspected stroke, who received treatment and prehospital warning with intelligent early warning system in Stroke Center of Changhai Hospital of Navy Medical University (Second Military Medical University) between Nov. 2017 and Jun. 2018, were retrospectively analyzed. Pre-hospital warning was defined as 120 alerting stroke teams using software before transferring patients to the target hospital. According to the in-hospital treatment methods, the patients were divided into non-stroke group, conservative treatment group, thrombolysis group, thrombectomy group, bridging group and cerebral hemorrhage group. The efficiency in each link of the intelligent early warning system, the ability of emergency doctor diagnosing stroke, the ability of emergency doctor diagnosing severe stroke using gaze-face arm speech time (G-FAST) scale, the speed of first aid response of the attending physician and the door-in-to-door-out (DIDO) time in primary stroke center were evaluated in each group. Results A total of 248 patients were included in this study, including 24 non-stroke patients and 224 stroke patients (101 patients in the conservative treatment group, 23 patients in the thrombolysis group, 32 patients in the thrombectomy group, 22 patients in the bridging group and 46 patients in the cerebral hemorrhage group). The median primary screening time, early warning time and response time of 248 patients were 28.0 (13.0, 92.5), 11.0 (7.3, 15.3) and 19.0 (13.0, 35.0) s, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 6 pre-hospital emergency physicians diagnosing severe stroke using G-FAST scale were 84%, 71%, 83%, 72% and 79%, respectively. Eight patients with severe stroke underwent whole-process monitoring of pre-hospital treatment, and had a median transport time of 113 (82, 142) min and a median DIDO time of 84 (12, 125) min. Conclusion Intelligent early warning system can realize the automation of data acquisition for transfer time points, making the data more comprehensive and reliable. It is helpful to analyze the efficiency of emergency physicians, drivers, stroke teams and primary stroke center in pre- and in-hospital connection in the treatment of stroke, so as to shorten the pre-hospital treatment time and improve the pre-hospital treatment efficiency.
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Objective To investigate into hand hygiene facilities and worker's practice of hand hygiene during 120 ambulance services in a capital city.Methods With the standard Observation Form publicized by the World Health Organization,field observation was carried out to monitor hand hygiene facilities and the practice of hand hygiene in workers during ambulance services provided by four service centers.Results A total of seven ambulances and 80 times of services were observed across a span of 21 days.The provision and position of hand hygiene facilities were found very limited in these ambulances.Of 656 times of presence of indictors for hand hygiene,the overall compliance rate was 3.04％ reflecting the practice of hand hygiene in ambulance workers.The compliance rate was found to be 0 (0/291),1.96％ (1/51),13.64％ (3/22),5.21％ (16/307) and 0(0/2) before touching patients,after body fluids exposure risk,before clean/aseptic procedures and after touching patients' surroundings respectively.Conclusions Poor practice of hand hygiene which was revealed in 120 ambulance services suggests the great need for education and training to improve patient safety and occupational health.
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Objective To establish a distinct linked emergency rescue network system in Shenzhen. Methods The current status of emergency network system in Shenzhen was studied, and some related publications in the recent years were reviewed. Results The emergency network system in Shenzhen is characterized by the following aspects: there is an effective emergency dispatch system with high authorities; the network covers every corner of Shenzhen; series of laws have been issued to ensure the proper operation of network. Conclusion The medical rescue system has developed in depth. The combination of community-based, pre-hospital and hospital rescue is effective in the whole process of emergency rescue, and shortens the rescue distance. The community-based rescue is the basic part of the system that can use the medical resources efficiently.
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Objective:To design a hanger-unnecessary infusion bottle and its tube. Methods:According to internal pressuring mechanism, the defects of height and direction-necessity of the present infusion bottles and tubes had been successfully overcome. Results:Fluid infusion can now be applied at any height, in any direction and position without any danger of air-entering into blood vessels. It is useful for pre-hospital rescue, battle-field, patient-transferring or urgent and large number of fluid/blood infusion.Conclusion:The design can be used both in hospitals as a present-used normal infusion bottles or bags and for pre-hospital hanger-unnecessary use. It can replace the present-used infusion bottles and their tubes.