Spatial and temporal distribution characteristics of pre-hospital first aid in Ali region and its counter measures / 中华急诊医学杂志

ABSTRACT

Objective:To put forward possible improvement measures through analyzing characteristics of pre-hospital first aid in Ali region and the problems confronted.Methods:The relevant data of pre-hospital first aid in the Emergency Department of Ali People's Hospital of Tibet from September 2015 to August 2019 were collected, and the epidemiological statistics were made. In addition, the number and cycle rule of pre-hospital first aid and the proportion of traffic injuries in pre-hospital first aid in different time periods were analyzed. The isochronous maps were drawn, and the residential areas, tourist attractions and main roads covered by the ground emergency medical service (GEMS) and helicopter emergency medical services (HEMS) at different periods were compared.Results:The epidemiology of pre-hospital first aid was mainly in middle-aged and young patients, accounting for 80.35%. Trauma patients were the most common in both non-native population (45.72%) and local residents, of which traffic injuries accounted for 66.43% of total trauma. Neurological emergency was the second most common among local residents (24.65%), and high altitude reaction was the second most common among non-native population (19.14%). From April to December every year, the amont of emergency treatment in Ali region increased periodically, and reached the peak from July to September. After eliminating the periodic influencing factors, the amount of pre-hospital first aid in Ali region showed a gradual increase over time. The regression equation was Y=15.7+0.27 X, F=36.809, P<0.05, R2=0.444. From April to December every year, the amount of pre-hospital first aid caused by traffic injuries increased significantly ( χ2= 10.819, P< 0.05). Within 15 min, GEMS could cover all the towns in Ali region, as well as the area where the first aid point was located and some villages that were pretty close to the first aid point, with a total of 49 villages (residences); Compared with 15 min, the pre-hospital resources could cover 75 villages (residences) and 4 tourist attractions within 1 h ( χ2 = 10.813, P < 0.05), and the main roads could cover about 788 km. If combined GEMS and HEMS, compared with the coverage of only one hour of ground emergency, the pre-hospital resources could cover 116 villages (residences) and 5 tourist attractions ( χ2 = 19.447, P < 0.05), and the main roads could cover about 1 234 km ( χ2 = 349.532, P < 0.05). Conclusions:HEMS combined with GEMS might fundamentally solve problem of comparatively small coverage of the emergency network in Ali region at present.