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[丹麦首都地区移动急救单元对热性惊厥的院前管理]

[Prehospital management of febrile convulsions by the Mobile Emergency Care Unit in the Capital Region of Denmark].

作者信息

Pedersen Ulf Gøttrup, Lindekaer Astrid Listor, Nielsen Søren Loumann

机构信息

Akutlaegebil Region Hovedstaden, Hovedbrandstationen, Afsnit 1553, HC Andersens Boulevard 23, DK-1553 København.

出版信息

Ugeskr Laeger. 2008 Nov 24;170(48):3962-6.

Abstract

INTRODUCTION

We conducted a quality assurance project of The Mobile Emergency Care Unit (MECU) in the Capital Region of Denmark when dispatched to febrile convulsions. The study focuses on prehospital treatment, comparison between prehospital and in-hospital diagnoses and parents' perceptions of their child's febrile convulsions and their satisfaction with the MECU.

MATERIAL AND METHODS

The period of investigation was from March 1st 2004 to March 31st 2005. Children with a diagnosis of febrile convulsions or relevant differential diagnoses were eligible for inclusion. Children were excluded if they had already been included, if their parents had no Danish address or if the questionnaire was not returned after a reminder was sent.

RESULTS

In the period of investigation, 333 children were eligible for inclusion, 290 questionnaires were sent, and 235 were returned, giving a response rate of 81%. The median age was 1 year (range: 0-7 years). In general, parents were satisfied with the MECU. Reasons of dissatisfaction are described. Most children (76%) were admitted without physician escort. A total of 37 children (16%) received diazepam therapy, of whom 15 (6%) were given intravenous diazepam. In 90% of cases, the prehospital and in-hospital diagnosis were identical.

CONCLUSION

In general, parents appreciate the service provided by the MECU. Reasons of dissatisfaction are described. On several occasions, the prehospital physician administered intravenous anticonvulsants, but we discuss if the MECU should still be dispatched primarily to febrile convulsions.

摘要

引言

我们在丹麦首都地区对移动急救单元(MECU)在接到高热惊厥出诊任务时开展了一项质量保证项目。该研究聚焦于院前治疗、院前与院内诊断的比较以及家长对其孩子高热惊厥的认知和对MECU的满意度。

材料与方法

调查期为2004年3月1日至2005年3月31日。诊断为高热惊厥或相关鉴别诊断的儿童符合纳入标准。若儿童已被纳入、其父母没有丹麦地址或在发出提醒后问卷未返回,则将其排除。

结果

在调查期内,333名儿童符合纳入标准,共发放290份问卷,回收235份,回复率为81%。中位年龄为1岁(范围:0 - 7岁)。总体而言,家长对MECU满意。文中描述了不满意的原因。大多数儿童(76%)在无医生护送的情况下入院。共有37名儿童(16%)接受了地西泮治疗,其中15名(6%)接受了静脉注射地西泮。在90%的病例中,院前和院内诊断一致。

结论

总体而言,家长认可MECU提供的服务。文中描述了不满意的原因。有几次,院前医生给予了静脉注射抗惊厥药物,但我们讨论了MECU是否仍应主要被派往处理高热惊厥情况。

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