Flabouris Arthas
NSW Medical Retrieval Service, CareFlight, P.O. Box 159, Westmead NSW 2145, Australia.
Injury. 2003 Nov;34(11):847-52. doi: 10.1016/s0020-1383(03)00033-0.
The critical incident technique, used in critical care related medical specialities as a quality tool, may be applicable for evaluation of pre hospital care for injured patients. This study describes events documented by medically staffed retrieval teams that occurred during a scene response. Incidents were defined as events, which may have or did reduce the safety margin for the patient and/or retrieval team. Positive events were defined as events that actually did, or had the potential to, positively influence the outcome for the patient and/or retrieval team task.257 patient transport records had documented events (216 incidents, 41 positive), 35.6% had multiple events. Doctor's experience correlated with event documentation, R(2)=0.614 (P<0.0001). Incidents occurred mostly during team dispatch, prior to arrival and whilst team was at the scene. Equipment related incidents accounted for 24.3% of incidents. Winch incidents accounted for 12% of equipment incidents. Environmental factors were associated with 14.3% of incidents. In conclusion, the description of events associated with a scene response can be used for quality evaluation. Incidents and positive events should be evaluated. Future evaluation can benefit by incorporating detailed information from a broader cross-section of retrieval organisations.
危急事件技术作为一种质量工具,用于重症监护相关医学专业,可能适用于评估受伤患者的院前护理。本研究描述了由配备医疗人员的救援团队记录的在现场响应期间发生的事件。事件被定义为可能已经或确实降低了患者和/或救援团队安全边际的事件。积极事件被定义为实际已经或有可能对患者和/或救援团队任务结果产生积极影响的事件。257份患者转运记录中有事件记录(216起事件,41起积极事件),35.6%有多个事件。医生的经验与事件记录相关,R(2)=0.614(P<0.0001)。事件大多发生在团队派遣期间、到达之前以及团队在现场时。与设备相关的事件占事件总数的24.3%。绞车事件占设备事件的12%。环境因素与14.3%的事件相关。总之,与现场响应相关的事件描述可用于质量评估。应评估事件和积极事件。未来的评估可以通过纳入来自更广泛的救援组织的详细信息而受益。