Seow E, Wong H P, Phe A
Department of Emergency Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore.
Emerg Med J. 2001 Jul;18(4):297-9. doi: 10.1136/emj.18.4.297.
(1) To determine the pattern of ambulance arrivals in the emergency department (ED) and (2) to review resource allocation based on these data.
All (13 697) ambulance arrivals in 1996 to the ED of Tan Tock Seng Hospital were studied and where relevant compared with the walk in and total arrivals of the same year. The following data were obtained from computer records: (a) patients' demographic data; (b) number of ambulance arrivals by hour; (c) the classification of the ambulance arrivals by emergency or non-emergency, trauma or non-trauma; (d) cause of injury for trauma cases; (e) discharge status.
The ambulance arrivals in 1996 constituted 12.4% of the patient load for this department. There was no difference in modes of patient arrival to the ED by sex and ethnic group. However, there was significant evidence to show that more patients age > 60 came by ambulance than those age < 12 (p << 0.01). Some 98.5% of the ambulance arrivals were emergencies; 40.7% of the ambulance arrivals were attributable to trauma versus 27.3% of the walk in arrivals. The majority of the trauma cases brought in by ambulance were because of road traffic accidents (15.3%) or home accidents (7.4%). The peak in ambulance arrivals was between 2100-2300 hours compared with 1000-1200 for the walk in arrivals. More than half of the ambulance arrivals were admitted.
In planning resource allocation and in the development of contingency plans, the resource use of ambulance patients and the pattern of their arrivals should be taken into account.
(1)确定救护车抵达急诊科的模式;(2)根据这些数据审查资源分配情况。
对1996年新加坡陈笃生医院急诊科的所有(13697例)救护车抵达病例进行研究,并在相关情况下与同年的步行就诊病例和总就诊病例进行比较。从计算机记录中获取以下数据:(a)患者的人口统计学数据;(b)每小时救护车抵达的数量;(c)救护车抵达按紧急或非紧急、创伤或非创伤分类;(d)创伤病例的受伤原因;(e)出院状态。
1996年救护车抵达病例占该科室患者总量的12.4%。患者抵达急诊科的方式在性别和种族方面没有差异。然而,有显著证据表明,60岁以上乘坐救护车前来的患者比12岁以下的患者更多(p << 0.01)。约98.5%的救护车抵达病例为紧急情况;40.7%的救护车抵达病例归因于创伤,而步行就诊病例中这一比例为27.3%。乘坐救护车送来的创伤病例大多数是由于道路交通事故(15.3%)或家庭事故(7.4%)。救护车抵达的高峰时间在21:00 - 23:00,而步行就诊的高峰时间在10:00 - 12:00。超过一半的救护车抵达病例被收治。
在规划资源分配和制定应急预案时,应考虑救护车患者的资源使用情况及其抵达模式。