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Objective To provide guidance for pre-hospital emergency treatment by studying the disease spectrum and distribution characteristics of pre-hospital emergency treatment patients in Wuxi area from 2015 to 2020. Methods The medical records of 120 pre-hospital emergency patients in Wuxi area from January 2015 to December 2020 were retrospectively analyzed, and the disease types, gender, age, and seasonal distribution of the pre-hospital emergency patients were statistically analyzed. Results The top five emergency diseases of 16 437 pre-hospital patients were trauma (24.51%), cerebrovascular disease (19.16%), cardiovascular disease (18.33%), digestive system disease (9.70%) and respiratory disease (7.20%). In the distribution of disease types, the proportions of injuries, cerebrovascular diseases, cardiovascular diseases, digestive system diseases, respiratory system diseases, poisoning diseases and urinary system diseases in males were significantly higher than those in females (χ2=4.975, P<0.05). The proportion of male species (9 812/16 437) was higher than that of female species (6 625/16 437). From 2015 to 2020, the age group with high incidence of pre-hospital emergency patients in Wuxi area was distributed in the 50-60 years old (19.30%) and 40-50 years old (16.28%), and the least age group was 0-10 years old (2.60%). The number of pre-hospital emergency patients was 46.60% from 6 to 12 hours per day, and 10.26% from 18 to 24 hours per day. The number of pre-hospital emergency patients was the highest in summer (38.69%), and the lowest in spring (11.87%). Conclusion The pre-hospital emergency diseases in Wuxi area are mainly cardiovascular and cerebrovascular diseases, and the acute and severe diseases show an increasing trend. It is necessary to rationally allocate the pre-hospital emergency resources according to the disease spectrum and the peak months and time periods of different diseases, so as to improve the medical service level in Wuxi.
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Objective:To observe the effect of two different screening scales used by 120 dispatchers to early identify stroke patients and give telephone guidance for treatment.Methods:From October 2018 to August 2019, 2 027 stroke and suspect stroke patients who called the Kaifeng 120 Emergency Center were enrolled. The differences in the final positive rate of stroke diagnosis and the incidence of adverse events were compared and analyzed in 1 020 cases using recognition of stroke in the emergency room (ROSIER) and 1 007 cases using facial drooping, arm weakness, speech difficulties and time (FAST) scale scores for telephone guidance.Results:The positive rate of stroke identification in ROSIER score group was higher than that in FAST score group [31.4% (320/1 020) vs. 29.3% (295/1 007)], the false report rate was significantly lower than that in FAST score group [14.9% (152/1 020) vs. 18.8% (189/1 007), P < 0.05], the incidence of adverse events caused by vomiting, falling from bed and convulsions in ROSIER score group were lower than those in FAST score group [0.5% (1/208) vs. 2.2% (4/185), 0% (0/26) vs. 20.0% (2/10), 2.1% (1/48) vs. 10.3% (3/29)], however, the incidence of adverse events caused by falling out of bed was significantly lower ( P < 0.05). The incidence of total adverse events in ROSIER score group was significantly lower than that in FAST score group [0.7% (2/305) vs. 3.8% (9/235), P < 0.05]. The time of FAST score group was shorter than that of ROSIER score group (minutes: 1.2±0.2 vs. 2.5±0.3), but the difference was not statistically significant ( P > 0.05). Conclusions:Two different scales can be used to early identify stroke patients and provide timely pre-hospital guidance, thus reduce the incidence of adverse events. Although the ROSIER score takes longer time, the dispatchers guide the patients by phone which does not affect the dispatch time.
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Objective To investigate the effect of active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) in patients with pre-hospital respiratory and cardiac arrest.Methods Forty-five patients with respiratory and cardiac arrest,and with contraindication of chest compression admitted to Baiyin Central Hospital of Gansu Province from March 2012 to September 2018 were enrolled,and they were divided into two groups according to random number table.AACD-CPR (abdominal compression-decompression group,n =24) and cardiopulmonary resuscitation (CPR) with unarmed abdominal compression (unarmed abdominal pressure group,n =21) were performed respectively.The success rate of rescue was observed in the two groups,and the changes in heart rate (HR),pulse oxygen saturation (SpO2) and blood pressure 30 minutes after CPR in patients with restoration of spontaneous circulation (ROSC) were observed.Results Among the 24 patients in the abdominal compression-decompression group,5 patients (20.83％) had ROSC,and 2 patients (9.52％) had ROSC in 21 patients of the unarmed abdominal pressure group.The success rate of resuscitation in the abdominal compression-decompression group was significantly higher than that in the unarmed abdominal pressure group (P ＜ 0.05).HR of ROSC patients at 30 minutes of CPR in abdominal compression-decompression group was significantly lower than that in unarmed abdominal compression group (bpm:139.45±5.08 vs.147.62±5.24,P ＜ 0.05),and SpO2 and blood pressure were significantly higher than those in unarmed abdominal compression group with significant differences [SpO2:0.92 ± 0.03 vs.0.85 ± 0.03,systolic blood pressure (SBP,mmHg,1 mmHg =0.133 kPa):118.23 ± 3.26 vs.98.51 ± 3.10,diastolic blood pressure (DBP,mmHg):60.10 ± 2.50 vs.56.36 ± 2.45,all P ＜ 0.05].Conclusion The effect of AACD-CPR was superior to that of unarmed abdominal pressure CPR,which had higher application value to rescue patients with respiratory and cardiac arrest with chest pressure contraindication.
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Objective To explore the nursing cooperation ofpre-hospital emergency trauma and hospital treatment intelligent network operation system seamless docking. Methods 56 cases of traumatic patients had surgical treatment in the hospital from July 1,2016 to November 30,2016 had pre-hospital emergency trauma hospital treatment intelligent network operation system (TPEITS) applied in emergency saving, at the same time of pre-hospital first aid, by CT and ultrasound B checking hospital appointments was finished with TPEITS system to open checking green channel and shorten the checking waiting time of patients. When the booking checking, operating room and emergency personnel appointment was finished through TPEITS system, open the green channel of the surgery, shorten the surgery patients waiting time,and in pre-hospital and hospital emergency care coordination were applied. Effective treatment time (patients disease onset to surgery time), rescue success rate, length of hospital stay and patients′satisfaction of the patients were statistically analyzed.And 32 cases of emergency trauma patients had normal pre-hospital emergency, hospital surgical treatment and nursing from February 1, 2016 to June 30,2016 were taken as control group.TPEITS system and regular pattern effective treatment time, rescue success rate, length of hospital stay and patients′ satisfaction, etc were compared. Results Effective treatment time and hospital stay of TPEITS system were(42.26±5.47)min and(36.45±9.85)d respectively,which were shorter than the(78.53±16.78)min and(48.28±12.55)d of regular pattern.And rescue success rate and patients′satisfaction of TPEITS system were 94.64%(53/56)and 92.86%(52/56) respectively,which were higher than the 75.00%(24/32)and 68.75%(22/32)of regular pattern(x2=5.500, 8.846, P<0.05). Conclusions Pre- hospital emergency trauma combined with hospital treatment intelligent network operation system seamless docking with good nursing can shorten the emergency response time, shorten the operation prepare time, improve the rescue effect and patient satisfaction,therefore,it worth clinical promotion.
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The paper introduces the development status and requirements for informatization construction of pre-hospital first-aid in Nanning Emergency Medical Service Center,illustrates the pre-hospital first-aid informatization construction and management and analyzes the effects of pre-hospital first-aid informatization construction,including improving the pre-hospital first-aid ability,overall command and scheduling ability and first-aid response ability,etc.
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To develop a new-type portable composite emergency treatment device with multi functions to e-liminate the deficiencies of the existing emergency treatment devices. Mechanics calculation and intensity analy-sis were involved in the design of the device by analyzing the characteristics of pre-hospital first aid in the primary med-ical facilities and the allocation of conventional medicine and materials. The device adopted a chest-like structure with some versatile truckles at the corners of the bottom, which could be transformed into the emergency materials storage chest, emergency trolley, emergency bed, worktable or stretcher. The device was versatile, mobile and convenient, and could be used for CPR, simple operation, transfusion and etc. The device can be employed for emergen-cy treatment of battle injury at war time, pre-hospital first aid at peace time or emergency support in the responses to the emergencies.
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Objective To investigate the application value of modified early warning score (MEWS) for assessment of patients in pre hospital first aid.Methods For patients with MEWS method in 3 478 cases of pre hospital first aid,scored in 0-4,5-9 and ≥ 10 points.Analysis of the relationship between the distribution and severity in patients with different grades,and tracing the fate and the condition of patients after admission.Results In MEWS patients with low 0-4 points was divided into pre hospital first aid,accounted for 69.18％ (2 406/3 478),severe cases accounted for 2.58％ (62/2 406); MEWS 5-9 accounted for 21.54％ (749/3 478),severe patients increased to 37.92％ (284/749); MEWS ≥ 10 points accounted for only 9.29％ (323/3 478),severe patients increased to 87.00％ (281/323).MEWS scores higher ratio in patients with severe more,MEWS 5-9 points,severe patients with MEWS ≥ 10 points 0-4 critical patients proportion (P ＜ 0.01).MEWS 5-9 points,≥ 10 points patients admitted to a specialist ward and intensive care units treatment compared with MEWS 0-4 points patients increased significandy (P ＜ 0.01),the mortality rate was also significandy increased (P ＜ 0.01).Conclusion The MEWS method in pre hospital first aid to early warning of potential in critically ill patients,the higher score,the more serious condition,the higher mortality rate.
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Objective To analyze the epidemiology of the emergency medical service in Urumqi City in 2011.Methods All patients from 120-Ambulance Center of Urumqi City admitted from January 1,2011 through December 30,2011 were enrolled for prospective study.Descriptive analysis the gender,age,race,underlying diseases,the peak of calling,the time taken by ambulance and so on.Results The 120-Ambulance Center answered overall 53786 callings,the callings of effective answer were 47260,while the ineffective answers were 6526 accounting for 13.8％,and the average number of answer per day was 147.The ratio of male to female was 1.61:1 ; the number of callings from Han nationality was predominant accounting for 68.87％ (37043 callings),and the number of callings from Weiwuer nationality was next to that from Han nationality.The five most common emergency problems were traffic injury,acute cardiovascular diseases,cerebro-vascular diseases,trauma and poisoning.There was no significant difference in monthly number of emergency cases during the 12 months of 2011,and the average monthly number of emergency cases was ranged in 2500-3500.The peak time of answering occurred in 10:00 am-13:00 pm、16:00 pm-18:00 pm、21:00 pm-24:00 pm; the ages of patients were dominant in the population of 20-29 years old、30-39 years old and 70-79 years old.Conclusions We should lay the emphasis on the most common diseases,the peak of answering,and the most vulnerable population,in order to come across with the theoretical and practical evidence to the relevant public health bureau for the improvement of transport mode carried out by 120-Ambulance Center in Urumqi City.
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Objective To investigate the differences in the epidemiological characteristics of patients in pre-hospital medical care before and after “5 · 12” Wenchuan earthhquake in Deyang city.Methods Comparison was made between the epidemiological features of cases treated in Deyang emergency medical center from the January 1,2007 through the December 31,2007 before the earthquake (the pre-earthquake group) and those treated from the January 1,2009 through the December 31,2009 after the earthquake ( the post-earthquake group) with the criteria of international classification of diseases (ICD-10).Results ( 1 ) There were 11 325 patients medically cared before earthquake and 16 265 patients after disaster.The distribution of sex,age,the top five causes,the seasonal and diurnal variations of emergency call,radius of service circle of pre-hospital medical care cases were no significantly different between the two groups ( P ＞ 0.05 ).( 2 ) The time required for scheduling ambulance and time consumed for the transportation of patients in the post-earthquake group were less than those in the pre-earthquake group ( P ＜ 0.05 ).Conclusions The efficiency of medical care done by 120 Emergency Command Center in Deyang city has been improved significantly in ease of without change in epidemiological features of patients after reconstruction of disaster area.
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@#Objective To explore the effect of psychological intervention of the patients with acute stroke in pre-hospital first aid. Methods 148 patients with acute stroke who had been treated by psychology in pre-hospital first aid were chosen and interviewed, comparing with 100 patients with acute stroke in hospital in same state. Results There was a significant difference between two groups about realization to disease, attitude to disease, mental reaction, treating confidence, compliance, and so on. Conclusion Psychological intervention can improve the patients with acute stroke in pre-hospital first aid effectly in the realization about disease, correct attitude about disease, capability of fighting diseases, confidence for recovery from the illness and compliance.
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Objective To survey the status quo on response time of Emergency Medical Service System (EMSS)in Beijing and analyze the influence,factors in order to explore the existent problems upon EMSS of Beijing for 2008 Beijing Olympic game Methods The quantitative and aualitative mehods were used.The data derived from the record of Beijing Emergency Medical Center on the second half of 2005 was described and analyzed.Results At present,the median of response times in Beijing 120 Emss is 16.5 min,with 14.3 min for Quartile range.The cumulate proportion was 2.28% for less than 5 min,whereas 19.20% for over 30 min. there were statistically significant differences in term of the areas and stations respectively.Conclusion The response time of Beijing EMSS is too long,and it is not to be compared to the developed eoumtries itn terms of swift reponse,we should explore and amalyze the influence factors from various angles and make effort to resolve it.
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Objective To realize remote wireless data transmission in mobile monitoring terminal of pre-hospital first aid so as to enhance the effect of pre-hospital aid,guarantee the reliability and real-time state of data transmission in mobile monitoring terminal of pre-hospital first aid.Methods The software and hardware of the mobile monitoring terminal of pre-hospital first aid were designed.Then,according to the specialty of the data transmission and requirements of the bandwidth,the choice of wireless network and the transport layer protocol of data transmission were analyzed,and the technology approach fitting for the system were proposed.The protocols selected were PPP and TCP/IP based on ?C/OS-Ⅱ.Results Application tests showed that this approach could satisfy system's requirement.It could transmit patient's vital signs parameters to hospital's monitoring equipment exactly in real-time during pre-hospital first aid.Conclusion This design creates the condition for remote hospital guide,resources planning of patient's admission and analysis of illness state,which is feasible for application.
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Using information on the Emergency Department of the Sino-Japanese Friendship Hospital-reconstructed in January of 2002-as primary data, the authors provide a general view of the model for the building, management and development of emergency departments in China in the 21" century. There are two aspects to the issue. One concerns the composition of the hardware architecture of the emergency department, including emergency medical service system(EMSS), modified layout and facilities, medico-technical departments with a complete range of functions, rational emergency medical service procedures as well as pie-hospital first aid and facilities for long-distance network medical treatment. The other concerns the composition of the software architecture of the emergency department, including the transformation of the employment system of emergency medical personnel, the change of emergency service concepts, the personnel performance and financial control of the emergency department, and the development of an emergency department culture.