Safety of optimized pre-hospital emergency transfer system for critically ill children / 中国小儿急救医学

ABSTRACT

Objective To study the influence of the optimized pre-hospital emergency transfer sys-tem on the safety, success rate and prognosis of pediatric patients. Methods A clinical data analysis was made of 1 015 cases of critically ill children delivered with the not-optimized pre-hospital emergency transfer system as group Ⅰ( Jan. 2007-Dec. 2009 ) and those of 1 431 with the optimized pre-hospital emergency transfer system as group Ⅱ(Jun. 2010-Dec. 2012). The preparation time for dispatch,critical illness scores before and after transport,transfer success rates and outcomes were compared between the two groups. Re-sults Before transfer,the critical illness score for group Ⅰ was 81. 73 ± 18. 11,for group Ⅱ78. 45 ± 20. 96, with groupⅡ being more critical(t=4. 154,P<0. 001) and needing respirator supporting and more vasoac-tive agents(50. 5%vs. 30. 2%;60. 8% vs. 51. 6%;P<0. 01). The dispatch delay for groupⅠand groupⅡwere(19. 34 ± 6. 45)min and (16. 19 ± 5. 89)min,respectively,actual time out for groupⅡwas shorter than that for groupⅠ(P<0. 001). The critical illness scores on arrival of ward were 83. 01 ± 16. 73 in groupⅠ, 83. 97 ± 17. 50 in group Ⅱ,the score for group Ⅱ being more improved than that for group Ⅰ( P<0. 05 ) . The transfer success rates, cure and improvement rates were higher in group Ⅱ compared with group Ⅰ(97. 6% vs. 94. 8%;94. 5% vs. 91. 0%;P<0. 01). Conclusion The application of the optimized pre-hos-pital emergency care system can improve the transfer efficiency and success rate,safety and treatment effect, reduce the mortality rate of pediatric patients.