Handolin Lauri E, Jääskeläinen Juhapetteri
Töölö Hospital, Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland.
Scand J Trauma Resusc Emerg Med. 2008 Nov 19;16:15. doi: 10.1186/1757-7241-16-15.
Pre-notification of an arriving trauma patient, given by transporting emergency medical unit, is needed in terms of facilitating the admitting emergency department to get ready for the patient before the patient actually arrives. In the present study we retrospectively analyzed the pre-hospital information provided by 700 consecutive pre-notification mobile phone calls in terms to asses the response of trauma team activation regard to pre-notified information such as vital signs and level of consciousness, mechanism of injury (MOI), and estimated elapsed time (EET) from the time of pre-notification phone call to arrival.
The median EET was 15 minutes (range 0 - 80 min, interquartile range 10 - 20 min). In 11% of the cases EET was 5 minutes or shorter. 17% of the patients were intubated and ventilated on scene at the time pre-notification phone call took place. The most commonly notified pre-hospitally diagnosed injuries were thoracic in 75 cases (11%), followed by unstable long bone (tibia, femur, humerus) fracture in 66 cases (9%), and abdominal injuries in 32 cases (5%). Trauma team was activated for 61% of 700 pre-notified patients. MOI without clinical symptoms was the reason for team activation in 75% of the cases. In 25% of the cases there were pre-hospitally observed clinical injuries or abnormalities in vital parameters.
Pre-notification phone call is of a crucial importance in organizing every day activities at a busy trauma centre, but it should not take place in too much advance. In any case, a pre-notification phone call, even on short notice, gives emergency department personnel some time to prepare for the incoming patient.
转运急救单位预先通知即将送达的创伤患者,有助于接收患者的急诊科在患者实际到达之前做好准备。在本研究中,我们回顾性分析了700个连续的预先通知手机来电所提供的院前信息,以评估创伤团队根据预先通知的信息(如生命体征、意识水平、损伤机制(MOI)以及从预先通知电话到到达的估计经过时间(EET))启动的反应。
EET的中位数为15分钟(范围0 - 80分钟,四分位间距10 - 20分钟)。在11%的病例中,EET为5分钟或更短。在预先通知电话拨打时,17%的患者在现场已进行气管插管和通气。院前最常报告的诊断损伤为胸部损伤75例(11%),其次是不稳定长骨(胫骨、股骨、肱骨)骨折66例(9%),腹部损伤32例(5%)。700例预先通知的患者中有61%激活了创伤团队。在75%的病例中,无临床症状的MOI是团队激活的原因。在25%的病例中,院前观察到临床损伤或生命参数异常。
预先通知电话对于繁忙创伤中心的日常活动组织至关重要,但不应过早进行。无论如何,即使是提前很短时间的预先通知电话,也能给急诊科人员一些时间为即将到来的患者做准备。