Analysis of all non-fatal self-harm cases in an urban area of Japan during pre- and peri-pandemic periods of COVID-19: a population-based study.

BACKGROUND: This study aimed to examine population-based characteristics of non-fatal self-harm in an urban area during pre- and peri-pandemic periods of COVID-19 by sex, age, and severity of self-harm, using pre-hospital medical emergency records. METHODS: We used a registry of all pre-hospital medical records of self-harm cases that occurred in Kawasaki City, Japan, between January 2018 and December 2021. Adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated using Poisson regression models with the log-transformed population by year, sex, age group, and ward as an offset term. RESULTS: During the 4-year study period, 1,534 patients were transported by ambulance due to non-fatal self-harm and were alive on arrival at the hospital. Among women, the number of non-fatal self-harm cases increased by 1.2-fold in 2021 compared with that in 2018. The incidence rate of "severe" non-fatal self-harm among men aged 19 years or younger in 2021 (IRR 4.82, 95% CI 1.25-18.65) and that among women aged 50-59 years in 2020 (IRR 2.51, 95% CI 1.06-5.95) significantly increased compared with that 2018 and 2019. The incidence rate of "mild" self-harm among women aged 20-29 years tended to be higher in 2021 than in 2018 and 2019 (IRR 1.42, 95% CI 0.95-2.12, P = 0.085). CONCLUSIONS: During the peri-pandemic period of COVID-19, the incidence rate of "severe" non-fatal self-harm among men aged 19 years or younger and women aged 50-59 years, as well as that of "mild" self-harm among women aged 20-29 years, sharply increased compared with that during the pre-pandemic period. Our findings suggest that in urban areas during public health crises such as a pandemic, it is important to take measures to reduce the risk of non-fatal self-harm in young women, in addition to strengthening counseling and support for young women at risk for completed suicide.

Examining the relationship between the pre-hospital incident scene management of the paramedic students and their anxiety levels and perception of leadership.

AIM: The aim of this study is to examine the relationship between the pre-hospital incident scene management of paramedic students and their anxiety levels and perception of leadership. METHOD: The sample of this descriptive correlational study consisted of 2nd-year students (N = 157) attending the associate degree program of the vocational school of healthcare services in two universities located in the eastern Turkey. No sample selection was used and the study was completed with 130 students. The data were collected using Socio-Demographic Data Form, Incident Scene Description Form, Intolerance of Uncertainty Scale, and Multidimensional Leadership Orientations Scale. The data were analyzed using number, percentage distribution, mean, and standard deviation. Normally distributed data were analyzed by correlation analysis. RESULTS: It was found that 65.4 % of the participants were female, 69.2 % received education on incident scene at the university, 52.3 % stated that this education was adequate, 58.5 % received education on leadership and crisis management at the university, and 60.7 % had no further suggestions for their education at the university. The mean scores of the students' knowledge on incident scene management were 15.77 ± 4.5, their total mean scores of the Intolerance of Uncertainty Scale were 35.38 ± 10.31, and their total mean scores of the Multidimensional Leadership Orientations Scale were 57.77 ± 20.26. A statistically significant negative very weak correlation was found between the Intolerance of Uncertainty Scale and the Multidimensional Leadership Orientations Scale (r = -0.225, p < 0.010). CONCLUSION: The results of this study revealed that the students had a low level of knowledge about crime scene management. As their anxiety levels increased, their perception of leadership decreased. It can be suggested to organize in-service and simulation trainings that will increase students' awareness of the courses related to crime scene management in their curriculum.

Role of pre-hospital emergency medical systems in the rescue of patients with ST-elevation myocardial infarction.

BACKGROUND: Myocardial infarction (MI) is a series of clinical syndromes caused by ischemic necrosis of myocardial cells that results from severe and persistent acute ischemia of the myocardium due to a dramatic reduction or interruption of coronary blood supply. OBJECTIVE: In this study, we analyzed the role of pre-hospital emergency services in the rescue of patients suffering from ST-elevation myocardial infarction (STEMI). METHODS: We enrolled 229 patients with STEMI who were transported to the Second Hospital of Tianjin Medical University by Tianjin Emergency Center from January 2017 to June 2021. With the development of the pre-hospital emergency medical system in Tianjin (2019) as the time node, the patients were divided into three groups: A (87 cases), B (68 cases), and C (74 cases). The onset-to-call time, emergency response time, door-to-balloon (D-B) time, first medical contact to balloon dilation (FMC-B) time, symptom onset-to-balloon dilation (S-B) time, proportion of patients receiving prehospital administration of bispecific antibodies, number of days hospitalized, total hospitalization expenses, and in-hospital incidence and mortality of heart failure were compared between the three groups. RESULTS: Group C differed significantly from group A and group B in terms of emergency response time, D-B time, FMC-B time, S-B time, the proportion of patients who received prehospital administration of bispecific antibodies, and the number of days of hospitalization (P< 0.05), but there was no significant difference in the onset-to-call time (P> 0.05) and the decreasing trends in the in-hospital incidence and mortality of heart failure were not statistically significant (incidence: 9.50% vs. 13.23%, 12.64%; mortality: 4.10% vs. 5.90%, 4.60%). CONCLUSION: A reasonable pre-hospital emergency medical network layout and resource investment, as well as the strengthening of the interface between pre-hospital and in-hospital medical emergencies and pre-hospital standardized rescue, can shorten the emergency response time and the total ischemic time in patients with chest pain, which can improve patient prognosis to a certain extent.

Provision of pre-hospital medical care for terrorist attacks.

The delivery of medical care to the severely injured during major incidents and mass casualty events has been a recurring challenge for decades across the world. From events in resource-poor developing countries, through richly funded military conflicts, to the most equipped of developed nations, the provision of rapid medical care to the severely injured during major incidents and mass casualty events has been a priority for healthcare providers. This is often under the most difficult of circumstances.1,2 Whilst mass casualty events are a persistent global challenge, it is clear in developed countries that patients and their families demand and expect a high standard of care from their rescuers, that this care should be delivered rapidly, and this should be of the highest quality possible.3 Whilst there is respect afforded to those who 'run towards danger' during a high-threat situation, first responders are subjected to a high degree of scrutiny for their actions, even when the circumstances they are presented with are considered to be extraordinary.4 Likewise, even for those who are catastrophically injured beyond salvage, society expects the response to be dignified, calculated, and thorough.3.

Estructura organizacional del policlínico Julián Grimau para la respuesta médica ante emergencias químicas por amoníaco / Organizational structure of Julián Grimau polyclinic for medical response to chemical emergencies by ammonia

Introducción: El amoníaco constituye riesgo de emergencia química en el Policlínico Docente Julián Grimau del municipio Arroyo Naranjo, lo que hace necesario asumir una estructura organizacional que viabilice la respuesta médica frente a este tipo de eventos. Objetivo: Diseñar una propuesta de estructura organizacional del policlínico Julián Grimau para la respuesta médica ante emergencias químicas por amoníaco. Métodos: Se realizó una investigación en sistemas y servicios de salud, entre septiembre de 2017 y diciembre de 2018, en el Policlínico Docente Julián Grimau. Se analizaron documentos relacionados con las acciones médicas en las emergencias químicas en la atención primaria de salud. Se empleó el método sistémico estructural-funcional para diseñar la estructura organizacional, y el informante clave para su concreción. Resultados: Se propone una estructura organizacional de la respuesta médica a emergencias químicas por amoníaco en el Policlínico Docente Julián Grimau que se conformó por nueve áreas: punto de recepción (1), tratamiento especial (2), clasificación (3), tratamiento de urgencia al intoxicado grave (4), tratamiento de urgencia al intoxicado leve (5), aseguramiento al diagnóstico (6), aseguramiento médico material (7), el área de fallecidos (8) y asintomáticos (9). Conclusiones: La estructura organizacional de la respuesta médica a emergencias químicas por amoníaco en el Policlínico Docente Julián Grimau quedó conformada en áreas con sustento en los principios clínicos, evolutivos y de tratamiento del paciente intoxicado agudo, donde se aprovechan las potencialidades orgánicas y funcionales de la institución. Se caracteriza por ser sistémica, flexible, objetiva, participativa, oportuna, adecuada y selectiva(AU)

Introduction: At Julián Grimau Teaching Polyclinic in Arroyo Naranjo municipality, ammonia is a risk of chemical emergency. Hence, it is necessary for the medical response to these situations to implement an organizational structure. Objective: Design a proposal of organizational structure in Julián Grimau Polyclinic for the medical response to chemical emergency by ammonia. Methods: A research was carried out on health systems and services, from September 2017 to December 2018, in Julián Grimau Teaching Polyclinic. A documentary analysis related to medical actions in chemical emergencies was conducted in primary health care's level. In addition, the following methods were used: structural-functional system for the design of the organizational structure and the key informant for its concretion. Result: It is proposed an organizational structure of the medical response to chemical emergencies by ammonia in the Polyclinic, that was formed by nine areas: reception point (1), special treatment (2), classification (3), emergency treatment to severe poisoned patient (4), emergency treatment to slightly poisoned patient (5), logistics for the diagnosis (6), medical-material logistics (7), deceased´s area (8), and asymptomatic patients (9). Conclusions: The organizational structure of the medical response to chemical emergencies by ammonia in Julián Grimau Teaching Polyclinic was formed of areas secured by principles of clinical, evolutive and of acute poisoned patient´s treatment where the organic and functional potentials of the institution are seized. Hence, this proposal is flexible, objective, participatory, timely, adequate and selective(AU)

Clinical and diagnostic findings in COVID-19 patients: an original research from SG Moscati Hospital in Taranto Italy.

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide medical challenge due to the scarcity of proper information and remedial resources. The ability to efficiently avoid a further SARS-CoV-2 pandemic will, therefore, depend on understanding several factors which include host immunity, virus behavior, prevention measures, and new therapies. This is a multi-phase observatory study conducted in the SG Moscati Hospital of Taranto in Italy that was converted into COVID-19 Special Care Unit for SARS-Co-V2 risk management. Patients were admitted to the 118 Emergency Pre-Hospital and Emergency Department based on two diagnostic criteria, the nasopharyngeal swab assessed by reverse-transcriptase-polymerase-chain-reaction (RT-PCR) and CT-scan image characterized by ground glass opacity. Patients were divided into four groups, positive-positive (ER-PP), negative-positive (ER-NP), negative-negative (ER-NN) and a group admitted to the ICU (ER-IC). A further control group was added when the T and B lymphocyte subsets were analyzed. Data included gender, age, vital signs, arterial blood gas analysis (ABG), extensive laboratory results with microbiology and bronchoalveolar lavage fluid (BALF) which were analyzed and compared. Fundamental differences were reported among the groups. Males were significantly higher in PP, ICU, and NP groups, from 2 to 4-fold higher than females, while in the NN group, the number of females was mildly higher than males; the PP patients showed a marked alkalotic, hypoxic, hypocapnia ABG profile with hyperventilation at the time of admission; finally, the laboratory and microbiology results showed lymphopenia, fibrinogen, ESR, CRP, and eGFR were markedly anomalous. The total number of CD4+ and CD8+ T cells was dramatically reduced in COVID-19 patients with levels lower than the normal range delimited by 400/µL and 800/µL, respectively, and were negatively correlated with blood inflammatory responses.

Visión sistémica para respuesta médica a emergencias químicas por amoníaco del policlínico Julián Grimau / Systemic approach for medical response to chemical emergencies by ammonia in Julián Grimau polyclinic

Introducción: En el Policlínico Docente Julián Grimau, del municipio Arroyo Naranjo, el amoníaco constituye riesgo de emergencia química que puede afectar parte de la población que atiende. De ahí, que sea necesario para la respuesta médica ante estas situaciones, tener en cuenta las especificidades de la institución y su carácter sistémico. Objetivo: Proponer un sistema de respuesta médica ante emergencia química por amoníaco en el Policlínico Docente Julián Grimau. Métodos: Se realizó una investigación en sistemas y servicios de salud, entre septiembre de 2017 y diciembre de 2018, en el Policlínico Docente Julián Grimau. Se realizó un análisis documental relacionado con las acciones médicas en las emergencias químicas, en la atención primaria de salud. Se utilizaron, además, los métodos: sistémico estructural-funcional para el diseño del sistema, y el informante clave para su concreción. Resultados: Se plantearon premisas teórico prácticas y se diseñó el sistema de respuesta del policlínico, en su fase de alarma, que asumió dos subsistemas: el de urgencia, conformado por los componentes: recepción, tratamiento especial, clasificación y tratamiento de urgencia; y, el de aseguramiento, constituido por los componentes humano, material y diagnóstico. Conclusiones: La estructura sistémica organizacional de la respuesta médica ante emergencias químicas por amoníaco en el Policlínico Julián Grimau se sustenta en premisas teórico-prácticas propias que determinan la estructura holística institucional para establecer el proceso desde un enfoque sistémico-estructural-funcional. De ahí que el sistema propuesto, para la fase de alarma sea flexible, objetivo, participativo, oportuno, adecuado y selectivo(AU)

Introduction: At Julián Grimau Teaching Polyclinic in Arroyo Naranjo municipality, ammonia is a risk of chemical emergency that can affect part of the population that it serves to. Hence, it is necessary for the medical response to these situations to take into account the specificities of the institution and its systemic character. Objective: Propose a medical response system for chemical emergency by ammonia in Julián Grimau Teaching Polyclinic. Methods: A research was carried out on health systems and services, from September 2017 to December 2018, in Julián Grimau Teaching Polyclinic. A documentary analysis related to medical actions in chemical emergencies was conducted in primary health care's level. In addition, the following methods were used: structural-functional systemic for the design of the system, and the key informant for its concretion. Result: Practical- theoretical premises were stated and the polyclinic's response system was designed, in its alarm phase, which assumed two subsystems: the emergency one, formed by the components: reception, special treatment, classification and emergency treatment; and, the assurance one, consisting of human, material and diagnostic components. Conclusions: The organizational systemic structure of the medical response to chemical emergencies by ammonia in the Julián Grimau Polyclinic is based on its own theoretical-practical premises that determine the institutional holistic structure to establish the process from a systemic-structural-functional approach. Hence, the proposed system for the alarm phase is flexible, objective, participatory, timely, adequate and selective(AU)

Sub30: Protocol for the Sub30 feasibility study of a pre-hospital Extracorporeal membrane oxygenation (ECMO) capable advanced resuscitation team at achieving blood flow within 30 ​min in patients with refractory out-of-hospital cardiac arrest.

BACKGROUND: Out-of-hospital cardiac arrest carries a poor prognosis with survival less than 10% in many patient cohorts. Survival is inversely associated with duration of resuscitation as external chest compressions do not provide sufficient blood flow to prevent irreversible organ damage during a prolonged resuscitation. Extracorporeal membrane oxygenation (ECMO) instituted during cardiac arrest can provide normal physiological blood flows and is termed Extracorporeal Cardio-Pulmonary Resuscitation (ECPR). ECPR may improve survival when used with in-hospital cardiac arrests. This possible survival benefit has not been replicated in trials of out-of-hospital cardiac arrests, possibly because of the additional time it takes to transport the patient to hospital and initiate ECPR. Pre-hospital ECPR may shorten the time between cardiac arrest and physiological blood flows, potentially improving survival. It may also mitigate some of the neurological injury that many survivors suffer. METHODS: Sub30 is a prospective six patient feasibility study. The primary aim is to test whether it is possible to institute ECPR within 30 ​min of collapse in adult patients with refractory out of hospital cardiac arrest (OHCA). The secondary aims are to gather preliminary data on clinical outcomes, resource utilisation, and health economics associated with rapid ECPR delivery in order to plan any subsequent clinical investigation or clinical service. On study days a dedicated fast-response vehicle with ECPR capability will be tasked to out-of-hospital cardiac arrests in an area of London served by Barts Heart Centre. If patients suffer a cardiac arrest refractory to standard advanced resuscitation and meet eligibility criteria, ECPR will be started in the pre-hospital environment. DISCUSSION: Delivering pre-hospital ECPR within 30 ​min of an out-of-hospital cardiac arrest presents significant ethical, clinical, governance and logistical challenges. Prior to conducting an efficacy study of ECPR the feasibility of timely and safe application must be demonstrated first. Extensive planning, multiple high-fidelity multiagency simulations and a unique collaboration between pre-hospital and in-hospital institutions will allow us to test the feasibility of this intervention in London. The study has been reviewed, refined and endorsed by the International ECMO Network (ECMONet). TRIAL REGISTRATION: Clinicaltrials. gov NCT03700125, prospectively registered October 9, 2018.

Extension of Medical Services of Hospitals under the Support of the Mobile APP Follow-up System / 医学信息学杂志

The paper introduces the extension of medical services of hospitals under the support of the mobile APP follow-up system and its system architecture and functions,and indicates that this system can be applied to promote the communication between doctors and patients,reduce the contradiction between doctors and patients,improve the quality of medical services,reduce the workload of medical care personnel,assist regional medical construction.

Optimum allocation for pre-hospital resource with big data analysis / 中华急诊医学杂志

Objective To This article mainly takes the Shenzhen Baoan people's Hospital pre-hospital department as the observation object,analyses the spacial site data distribution of pre-hospital,to realize optimum allocation for pre-hospital resource.Methods By means of the intelligentized ambulance,the site data of the pre-hospital is obtainecd,so is the pre-hospital hot map.With the hot map,the special pre-hospital characteristics is researched.Results The three spatial data characteristics of pre-hospital medical are proposed,i.e.,non-uniform,relative stability,individual difference.Conclusions These three characteristics provide us with a new method and a new basis for decision making.In this paper,based on the pre-hospital characteristic,a modeling method of non-uniform relative stability model is proposed,and the optimized distribution of hospital site is discussed by applying planning mathematics.

Does the Norwegian emergency medical dispatch classification as non-urgent predict no need for pre-hospital medical treatment? An observational study.

BACKGROUND: The number of ambulance call-outs in Norway is increasing owing to societal changes and increased demand from the public. Together with improved but more expensive education of ambulance staff, this leads to increased costs and staffing shortages. We wanted to study whether the current dispatch triage tools could reliably identify patients who only required transport, and not pre-hospital medical care. This could allow selection of such patients for designated transport units, freeing up highly trained ambulance staff to attend patients in greater need. METHODS: A cross-sectional observational study was used, drawing on all electronic and paper records in our ambulance service from four random days in 2012. The patients were classified into acuity groups, based on Emergency Medical Dispatch codes, and pre-hospital interventions were extracted from the Patient Report Forms. RESULTS: Of the 1489 ambulance call-outs included in this study, 82 PRFs (5 %) were missing. A highly significant association was found between acuity group and recorded pre-hospital intervention (p ≤ 0.001). We found no correlation between gender, distance to hospital, age and pre-hospital interventions. Ambulances staffed by paramedics performed more interventions (234/917, 26 %) than those with emergency medical technicians (42/282, 15 %). The strongest predictor for needing pre-hospital interventions was found to be the emergency medical dispatch acuity descriptor. DISCUSSION: This study has demonstrated that the Norwegian dispatch system is able to correctly identify patients who do not need pre-hospital interventions. Patients with a low acuity code had a very low level of pre-hospital interventions. Evaluation of adherence to protocol in the Emergency Medical Dispatch is not possible due to the inherent need for medical experience in the triage process. CONCLUSIONS: This study validates the Norwegian dispatch tool (Norwegian index) as a predictor of patients who do not need pre-hospital interventions.

The epidemiological analysis of patients in pre-hospital medical care in large and medium-sized cities in China / 中华急诊医学杂志

Objective To investigate the epidemiological information of patients in pre-hospital medical care for our large and medium-sized cities and probe the patients' characteristic. Method The data in 2008 were exported from the computer databases of 8 large and medium-sized cities' emergency medical centers in our country.The thorough records of data were conducted to statistical analysis. Results ( 1 ) The scheduling time, running time, rescue time, returning time, total time and service radius in the pre-hospital medical care group were 2.16± 1.10(min), 14.01 ±6.82(min), 12.12±5.96(min), 14.08± 6.85(min), 42.34± 20.21(min)and 8.50±4.18(km), and the above parameter in the non-death group were 2.19 ± 1.13(min), 14.15 ± 7.14(min),11.60±6.72(min), 14.92 ±6.89(min), 41.86± 19.53(minutes) and 8.63±4.31(Km), and the above parameter in the death group were 2.10± 1.08(min), 13.68 ± 7.14(min), 25.25 ± 12.34(min), 13.75±6.48(min), 54.74 ± 25.47(min) and 7.86± 3.91(Km), and the above parameter in the non-sudden cardiac death group were2.09± 1.03(min), 13.58±6.78(min), 25.53± 12.34(min), 13.60± 6.54(min), 53.79±23.77(min) and 7.67 ± 3.86(Km), and the above parameter in the sudden cardiac death group were 2.12 ±1.02(min), 14.10±7.05(min), 24.79± 12.08(min), 13.79±6.61(min), 54. 80 ± 25. 36( min) and 7.90±3.92(Km) respectively. The scheduling time, running time, returning time and service radius in the death group were less than those of the non-death group, but the rescue time and total time of the former were more than those of the latter respectively ( P ＜ 0.05 or P ＜ 0. 001 ). The scheduling time and returning time didn' t have significant difference between the sudden cardiac death group and the non-sudden cardiac death group respectively ( P ＞ 0.05), but the running time, total time and service radius of the sudden cardiac death group were more than those of the non-sudden cardiac death group, and the rescue time of the former was less than that of the latter respectively ( P ＜ 0.05 or P ＜ 0.001 ). (2)The patients' amount in pre-hospital medical care group, the non-death group, the death group, the non-sudden cardiac death group and the sudden cardiac death group were at most in first quarter, and the least time slice of patients' amount were 4:00～ 6:00, 4:00～6:00, 4:00～ 6:00, 22:00～ 24:00, 2:00～4:00 respectively, and the most time slice of patients' amount were 20:00～ 22:00, 20:00～22:00, 8:00～ 10:00, 2:00 ～ 4:00, 8:00 ～ 10:00 respectively. (3)In 241 876 cases of pre-hospital medical care group, the patients' amount of trauma was at most, whose age grades was by far among21 ～50, and the others in sequence were nervous system, circulatory system, other group, digestive system, respiratory system and poisoning group respectively, whose age grades in nervous system, circulatory system and respiratory system was by far above 51, especially above 70. The patients' age grades in other group and digestive system had two climax age groups, which the one was 21 ～ 30, and the other was above 70. The patients' age grades in poisoning group was by far among 21 ～ 50, which the patients' amount of acute alcoholism was at the most. (4) In 12 568 cases of death group, the death amount of circulatory system, other group, respiratory system, nervous system and digestive system ranked at the lst,2nd,4th,5th 8th respectively, whose age grades was by far above 51, especially above 70,and the patients' amount of sudden cardiac death was at the most in the death amount of circulatory system. The death amount of trauma and poisoning group ranked at the 3rd, 6th respectively, whose age grades was by far among 21 ～ 50. (5)The total amount, the death amount and the sudden cardiac death amount of male patients were more than those of female patients. (6)The percentage of the death group to the pre-hospital medical care group was 5.20%, and the percentage of the sudden cardiac death group to the pre-hospital medical care group was 1.29%,and the percentage of the sudden cardiac death group to the death group was 24.87 %, and the percentage of the sudden cardiac death group to the circulatory system group was 67.33 %. Conclusions ( 1 )The trauma and the sudden cardiac death are the overriding reason of disease and the overriding reason of death in our large and medium-sized cities respectively. (2) It is very important to cut the death rate of the middle-old age patients by strengthening prevention and cure of cardiovascular and cerebrovascular diseases, discerning the critical illness early and improving the level of pre-hospital medical care. (3)It is a strong method to decrease the total amount and the death amount of the trauma, especially in traffic accident, by strengthening safety in production, observing traffic regulation and enhancing the legal awareness.

Vulnerabilidade ao stresse em profissionais de emergência médica pré-hospitalar / Vulnerability to stress in pre-hospital medical emergency professionals / La vulnérabilité au stress chez les professionnels de cas d’urgence médicale préhospitalière / Vulnerabilidad al estrés en profesionales de emergencias médicas pre-hospitalarias

Os estudos efectuados com os profissionais de emergência médica pré-hospitalar em Portugal são ainda extremamente reduzidos, embora a problemática se encontre mais desenvolvida em países como os EUA, Canadá e Japão. Neste sentido, pelas características próprias desta profissão interessa compreender de forma mais aprofundada em que medida se encontram estes profissionais vulneráveis ao stresse, sendo este o objectivo principal deste estudo. A amostra foi constituída por 161 profissionais de emergência médica distribuídos pelo (Técnico de Ambulância de Emergências / Tripulante de Ambulância de Emergências), território nacional dos quais 42,2% possuem a categoria profissional de TAE/TAS ( 31,7% são Enfermeiros e 26,1% são médicos, tendo sido utilizada uma amostragem por clusters, seguida da técnica de amostragem aleatória. Os resultados indicam a existência de médias globais baixas de vulnerabilidade ao stresse. No que diz respeito às alterações do sono, verificou-se a existência de diferenças estatisticamente significativas nas dimensões "Perfeccionismo e intolerância à frustração", "Condições de vida adversas", "Dramatização da existência", "Subjugação", e "Deprivação de afectos e rejeição", assim como para a totalidade do instrumento de medida do stresse. Os sujeitos de estudo que não praticam exercício físico apresentam valores médios de vulnerabilidade ao stresse mais elevados. (AU)

Research with pre-hospital medical emergency professionals in Portugal is still extremely reduced, even though this matter is better developed in countries such as the USA, Canada and Japan. Therefore, the characteristics inherent to this profession produce the interest to comprehend more thoroughly the vulnerability of these professionals to stress, which was the main objective of the present study. The sample was constituted by 161 medical emergency professionals distributed throughout the national territory; 42,2% of them possess the professional category of TAE/TAS, 31,7% are nurses, and 26,1% are physicians. We used the clusters sampling method, followed by the aleatoric sampling technique.The results indicate the existence of low global averages in vulnerability to stress. “Perfectionism and intolerance to frustration”, “Adverse life conditions”, “Dramatization of existence”, and “Deprivation of affects and rejection”, as well as to the totality of the stress assessment instrument. The subjects of the study that did not practice exercises presented higher stress vulnerability average values. (AU)

Les études effectuées sur les professionnels de cas d’urgence médicale pré-hospitalière au portugal sont encore extrêmement réduites, bien que cette problématique se trouve plus développée dans certains pays comme les états-unis, Le canada et le japon. dans ce sens, par les caractéristiques propres à cette profession, il est intéressant de comprendre de manière plus approfondie en quelle mesure ces professionnels se trouvent vulnérables au stress, cela étant l’objectif principal de cette étude. L’échantillon était constitué de 161 professionnels de l’urgence médicale distribuée sur tout le territoire national, desquels 42,2 % possédaient la catégorie professionnelle de tae/tas, 31,7 % étaient infirmiers, et 26,1 % médecins ; on a utilisé un échantillonnage par partitionnement des données, suivie de la technique de l’échantillonnage aléatoire. les résultats indiquent une moyenne globale basse de vulnérabilité au stress. toutefois il existe des différences statistiquement significatives entre la vulnérabilité au stress et la catégorie professionnelle. en ce qui concerne les altérations du sommeil on vérifie l’existence de différences statistiquement significatives dans les dimensions “perfectionnisme et intolérances à la frustration”, “conditions de vie adverses”, “dramatisation de l’existence”, “subjugation”, “privation d’affects et rejet”, comme pour la totalité de l’instrument de mesure du stress. les sujets d’étude qui ne pratiquent pas d’exercice physique présentent des valeurs moyennes de vulnérabilité au stress plus élevées. (AU)

Los estudios efectuados a profesionales de emergencias médicas pre-hospitalarias en Portugal son aún extremadamente reducidos, aunque la problemática se encuentre más extendida en paises como EUA, Canadá y Japón. En este sentido y por las características propias de esta profesión, nos interesa comprender de manera más profunda en que medida se encuentran vulnerables al estrés estos profesionales, siendo éste el objetivo principal de este estudio. La muestra estuvo compuesta por 161 profesionales de emergencias médicas, distribuidos por el territorio nacional, de los cuales 42.2% poseen la categoria de TAE/TAS (Técnico de Ambulancia de Emergencias / Tripulante de Ambulancia de Emergencias), 31.7% son enfermeros y 26.1% son médicos, habiendo sido utilizada una muestra por clusters, seguida de la técnica de la muestra aleatoria. Los resultados arrojaron la existencia de promedios globales bajos de vulnerabilidad al estrés. En lo que respecta a las alteraciones del sueño, se verificó la existencia de diferencias estadísticamente significativas en las dimensiones “Perfeccionismo e intolerancia a la frustración”, “Condiciones de vida adversas”, “Dramatización de la existencia”, Subyugación” y “Privación de afectos y rechazo”, así como también para la totalidad del instrumento de medida del estrés. Los indivíduos del estudio que no realizan ejercicios físicos presentan valores promedio de vulnerabilidad al estrés más elevados. (AU)

Appraisal of electronic administration analysis system used for pre-hospital records / 中华急诊医学杂志

Objective To study the value of electronic administration analysis system used for pre-hospitalrecords in comparison with statistic data processed manually. Method The data of 'first aid medical records'collected from June 26, 2007 to December 26, 2007 in Wuxi Emergency Center, Wuxi, China were taken for anal-ysis. The items for comparison included the average number of emergency patients monthly, percentage of intra-venous infusion, proportion of ECG and blood oxygen saturation monitoring, rate of blood glucose measurement,number of pre-hospital treatment, frequency of using medical devices and time taken for answer to inquires. Thecomparison was carried out between statistic data processed manually and those processed electronically. ResultsBetween two different methods of statistic process, there were no significant in all items ( P > 0.05) except theshorter time required for electronic process to answer the inquires (P<0.01). Conclusions The electronic ad-ministration analysis system for the records of emergency patients is fully developed to meet the expectation in termsof quick answer to inquries with credibly and precisely numerical values.