Maas Cortes L, Hargarten S W
Injury Research Center at the Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Acad Emerg Med. 2001 Sep;8(9):925-9. doi: 10.1111/j.1553-2712.2001.tb01156.x.
To assess the effectiveness of an emergency department (ED)-based strategy to identify and counsel selected patients about the importance of an operational smoke detector in the home and to offer a graded recommendation regarding such a strategy.
A systematic review was facilitated through the use of a structured template, a companion explanatory piece, and a grading and methodological scoring system based on published criteria for critical appraisal. Two Medline combined searches were performed using the following terms: emergency medical services and counseling, protective devices and smoke detectors, accidents, home, burns, fires, and residential fires. A free-text search of indexed and nonindexed citations in Emergency Medical Abstracts from 1977 to 1999 and a search of the Cochrane Library were also performed. In addition, reviewers performed independent Medline searches and suggested four additional studies. Studies selected for inclusion in this systematic review were required to meet the following criteria: 1) report ED-based research and 2) address the topic of fire and burn prevention with some pertinent discussion of ED-based interventions. The initial inclusion criteria had restricted studies to those that reported the results of counseling strategies for smoke detectors. The authors later decided to consider, as indirectly relevant, studies that did not investigate counseling strategies. Data from the selected studies were extracted using the template form, and the validity and applicability of the results to emergency practice were assessed. Recommendations were derived following criteria developed by a systematic review of preventive interventions in the ED.
Six articles were closely reviewed. Four of the six studies met the inclusion criteria. One other study that did not meet the inclusion criteria was also considered. No study focused specifically on the counseling of ED patients about smoke detectors.
Following the criteria of the graded recommendations used for the parent project. a recommendation cannot be made either for or against an ED-based strategy to counsel patients on the importance of smoke detectors. No studies located in our review directly assessed the effectiveness of such a strategy. Based on the retrospective case series study of the potential opportunity for a home fire safety intervention during an emergency medical services visit and the Safe Block Project study, it may be worthwhile to consider further research on the effectiveness of systems-level/structural interventions, with a targeted focus on strategies that attempt to overcome barriers associated with active interventions.
评估基于急诊科（ED）的策略的有效性，该策略用于识别特定患者并就家中运行正常的烟雾探测器的重要性进行咨询，并针对此类策略提供分级建议。
通过使用结构化模板、配套解释性文章以及基于已发表的批判性评价标准的分级和方法评分系统，促进了系统评价。使用以下术语进行了两次Medline联合检索：紧急医疗服务与咨询、防护设备与烟雾探测器、事故、家庭、烧伤、火灾和住宅火灾。还对1977年至1999年《紧急医疗摘要》中索引和未索引的引文进行了自由文本检索，并检索了Cochrane图书馆。此外，评审人员进行了独立的Medline检索，并推荐了另外四项研究。纳入本系统评价的研究需符合以下标准：1）报告基于急诊科的研究；2）涉及火灾和烧伤预防主题，并对基于急诊科的干预措施进行一些相关讨论。最初的纳入标准将研究限制在那些报告烟雾探测器咨询策略结果的研究。作者后来决定将未调查咨询策略的研究视为间接相关研究。使用模板表格提取所选研究的数据，并评估结果对急诊实践的有效性和适用性。根据对急诊科预防性干预措施的系统评价制定的标准得出建议。
对六篇文章进行了仔细审查。六项研究中有四项符合纳入标准。还考虑了另一项不符合纳入标准的研究。没有研究专门关注对急诊科患者进行烟雾探测器咨询。
按照母项目使用的分级建议标准，无法对基于急诊科的策略是否就烟雾探测器的重要性向患者提供咨询提出支持或反对的建议。我们的综述中没有找到直接评估此类策略有效性的研究。基于对紧急医疗服务就诊期间家庭消防安全干预潜在机会的回顾性病例系列研究以及安全街区项目研究，可能值得进一步研究系统层面/结构性干预措施的有效性，重点关注旨在克服与积极干预相关障碍的策略。
