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[紧急医疗服务基础设施。2001年和2005年巴登-符腾堡州配备医生的救护车设备比较]

[Infrastructure of emergency medical services. Comparison of physician-staffed ambulance equipment in the state of Baden-Wuerttemberg in 2001 and 2005].

作者信息

Genzwürker H, Lessing P, Ellinger K, Viergutz T, Hinkelbein J

机构信息

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim.

出版信息

Anaesthesist. 2007 Jul;56(7):665-72. doi: 10.1007/s00101-007-1194-9.

Abstract

BACKGROUND

A survey amongst emergency physician bases in the federal state of Baden-Wuerttemberg in 2001 concerning equipment available for airway management and the treatment of acute coronary syndromes showed striking differences with respect to implementation of European norms and international recommendations. The survey was repeated in 2005 to evaluate the development of the equipment in physician-staffed ambulance systems.

METHODS

A questionnaire was sent to all emergency physician bases (ground ambulance and helicopter) registered with the Ministry of Health in Baden-Wuerttemberg. Questions encompassed availability of options to verify correct tracheal tube position (e.g. capnometry), supraglottic airway devices as alternatives to mask ventilation and tracheal intubation, 12-lead ECG and fibrinolytic agents.

RESULTS

In 2001, 116 out of 127 bases (91.3%) participated and in 2005, 107 out of 120 bases (89.2%) returned the questionnaire. With availability in 97.2% of bases, prevalence of supraglottic airway devices is almost state-wide (2001: 54.3%, p<0.001, Fisher's exact test). The topics verification of tracheal tube position (2005: 73.8%, 2001: 26.7%, p<0.001), 12-lead ECG (2005: 89.7%, 2001: 52.6%, p<0.001) and fibrinolytic therapy (2005: 59.8%, 2001: 12.9%, p<0.001) showed noticeable increases in the corresponding availability, however, distinct regional structural deficits were still present in 2005.

CONCLUSIONS

A favourable trend could be found concerning the equipment of physician-staffed ambulances state-wide. Further efforts must be undertaken to ensure the complete implementation of legal requirements and international recommendations concerning provision of medical equipment.

摘要

背景

2001年对巴登-符腾堡州的急救医师基地进行的一项关于气道管理和急性冠状动脉综合征治疗可用设备的调查显示,在欧洲规范和国际建议的实施方面存在显著差异。2005年重复进行了该调查,以评估配备医师的救护车系统中设备的发展情况。

方法

向巴登-符腾堡州卫生部登记的所有急救医师基地(地面救护车和直升机)发送了一份问卷。问题包括验证气管导管位置的选项(如二氧化碳监测)的可用性、作为面罩通气和气管插管替代方案的声门上气道装置、12导联心电图和纤维蛋白溶解剂。

结果

2001年,127个基地中的116个(91.3%)参与了调查,2005年,120个基地中的107个(89.2%)返回了问卷。声门上气道装置的普及率在97.2%的基地中存在,几乎覆盖全州(2001年:54.3%,p<0.001,Fisher精确检验)。气管导管位置验证(2005年:73.8%,2001年:26.7%,p<0.001)、12导联心电图(2005年:89.7%,2001年:52.6%,p<0.001)和纤维蛋白溶解疗法(2005年:59.8%,2001年:12.9%,p<0.001)等方面的相应可用性有明显增加,然而,2005年仍存在明显的地区结构缺陷。

结论

在全州配备医师的救护车设备方面可以发现一个有利的趋势。必须进一步努力确保全面实施关于提供医疗设备的法律要求和国际建议。

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