Grange Jeff T, Baumann Gregory W, Vaezazizi Reza
Department of Emergency Medicine, Loma Linda University Medical Center, Loma Linda, California 92354, USA.
Prehosp Emerg Care. 2003 Jul-Sep;7(3):322-6. doi: 10.1080/10903120390936518.
To prospectively determine if on-site physicians at a mass gathering reduced the number of ambulance transports to local medical facilities. The authors also wished to determine the level of care provider (emergency medical technician, EMT-P, registered nurse, or medical doctor) required to treat and disposition each patient.
This study determined whether each patient presenting to on-site first aid stations at California Speedway during a large motorsports event would require ambulance transport to the hospital per the local emergency medical services (EMS) protocols. Whether the on-site physician prevented certain ambulance transports also was determined. Additionally, the minimum level of provider that could treat and disposition each patient was determined.
On-site physicians significantly reduced (p < 0.001) the number of ambulance transports at this mass gathering. Ambulance transports to local hospitals were reduced by 89% (from 116 to 13). Fifty-two percent of the patients were able to be treated and dispositioned (cardiac arrests, minor first aid, etc.) by a paramedic. Registered nurses were able to treat and disposition another 39% of the patients with pre-established protocols written by the track medical director. These patients had abrasions requiring tetanus shots, mild to moderate heat exhaustion that resolved with intravenous hydration, and other minor complaints. Finally, about 9% of the patients required physician-level care (suturing, prescriptions, etc.) to treat and disposition them.
On-site physician-level medical care at large mass gatherings significantly reduces the number of patients requiring transport to hospitals, thus reducing the impact on the local EMS system and surrounding medical facilities.
前瞻性地确定在大型集会现场的医生是否减少了转运至当地医疗机构的救护车数量。作者还希望确定治疗和处置每位患者所需的护理人员水平（急救医疗技术员、高级急救医疗技术员、注册护士或医生）。
本研究根据当地紧急医疗服务（EMS）协议，确定在一场大型赛车活动期间前往加利福尼亚赛道现场急救站的每位患者是否需要救护车转运至医院。还确定了现场医生是否阻止了某些救护车转运。此外，确定了能够治疗和处置每位患者的最低护理人员水平。
在这次大型集会中，现场医生显著减少了（p < 0.001）救护车转运的数量。转运至当地医院的救护车数量减少了89%（从116辆降至13辆）。52%的患者能够由护理人员进行治疗和处置（心脏骤停、简单急救等）。注册护士能够根据赛道医疗主任制定的既定方案，对另外39%的患者进行治疗和处置。这些患者有需要注射破伤风疫苗的擦伤、通过静脉补液缓解的轻度至中度中暑，以及其他轻微不适。最后，约9%的患者需要医生级别的护理（缝合、开处方等）来进行治疗和处置。
在大型集会中提供医生级别的现场医疗护理可显著减少需要转运至医院的患者数量，从而减轻对当地EMS系统和周边医疗机构的影响。
