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Objective To study the comprehensive quality of pre-hospital care of patients with acute coronary syndrome (ACS) in our country,and the factors affecting the efficiency of medical intervention of pre-hospital care.Methods An epidemiological investigation with target population-based cross-sectional study was carried out,and specifically designed questionnaire for determining the efficiency of pre-hospital care of patients with ACS was used to collect information of 272 patients from 13 emergency pre-hospital care centers.Results After analysis of the data from 13 majormedical centers,it could be classified into 4 patterns of pre-hospital care,namely directive pattern,pre-hospital pattern,dependent pattern and independent pattern.The results of analysis showed that the distance for ambulance driving in directive pattern was shorter than that in dependent pattern,but the call-response in directive pattern was quicker than that in pre-hospital pattern and dependent pattern,while the call-arrival time in directive pattern was longer than that in independent pattern and dependent pattern.The analysis of the on-site preliminary treatment in four patterns of pre-hospital care showed that there were differences in the establishment of intravenous access,aspirin,nitrate and ECG ( P ＜ 0.05 ).The total effective rate of pre-hospital care for ACS was 48％,while effective rate of independent pattern reached 70％.Factors affecting therapeutic effect on ACS resulting in better outcomes included pre-hospital pattern ( OR =4.097 ),directive pattern ( OR =5.158 ),and use of nitrate ( OR =3.045 ) and oral administration of medicine ( OR =8.215 ). Conclusions Independent pre-hospital pattern had the best therapeutic effect in the pre-hospital care of patients with ACS,and pre-hospital pattern had the best on-site preliminary disposal.Use of nitrate and oral administration of medicine showed the best benefit to the therapeutic effect.
RESUMEN
Hainan is an island province in south China with a high frequency of unconventional emergencies due to its special geographic location and national military defense role. Given the limited transportation route from Hainan to the outside world, self-rescue is more important to Hainan Province than other provinces in China and it is therefore imperative to establish an independent, scientific as well as efficient provincal disaster medical system in Hainan. The regulatory role for vulnerability analysis/assessment has been demonstrated in establisment of disaster medical system in varoius countries and or regions. In this paper, we attempt to describe/propose how to adopt vulnerability assessment through mathematical modeling of major biophysical social vulnerability factors to establish an independent, scientific, effieicnt and comprehensive provincial disaster medical system in Hainan.