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斯堪的纳维亚国家的院前医生主导的紧急医疗服务——跨国界的相同概念?

Scandinavian pre-hospital physician-manned Emergency Medical Services--same concept across borders?

机构信息

Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway.

出版信息

Resuscitation. 2010 Apr;81(4):427-33. doi: 10.1016/j.resuscitation.2009.12.019. Epub 2010 Feb 1.

Abstract

BACKGROUND

In Scandinavia, scattered populations and challenging geographical and climatic conditions necessitate highly advanced medical treatment by qualified pre-hospital services. Just like every other part of the health care system, the specialized pre-hospital EMS should aim to optimize its resource use, and critically review as well as continuously assess the quality of its practices. This study aims to provide a comprehensive profile of the pre-hospital, physician-manned EMS in the Scandinavian countries.

METHODS

The study was designed as a web-based cross-sectional survey. All specialized pre-hospital, physician-manned services in Scandinavia were invited, and data concerning organization, qualification and medical activity in 2007 were mapped.

RESULTS

Of the 41 invited services, 37 responded, which corresponds to a response rate of 90% (Finland 86%, Sweden 83%, Denmark 92%, Norway 94%). Organization and education are basically identical. All services provide advanced life support and have short response intervals. Services take care of a variety of patient groups, and skills are needed not only in procedures, but also in diagnostics, logistics, intensive care, and mass-casualty management. Consistent and detailed medical documentation was often lacking, however. Differences are mainly related to time variables, patient volume, and service area. The Danish and Swedish services have higher volumes of patient care encounters while the Finnish and Norwegian ones provide a wider variety of medical services.

CONCLUSIONS

This survey documented several significant similarities among pre-hospital physician-staffed EMS systems in Scandinavia. Although medical data registration is currently under-developed, Scandinavian physician-manned EMS is a feasible arena for future multi-centre research.

摘要

背景

在斯堪的纳维亚,分散的人口和具有挑战性的地理及气候条件需要由合格的院前服务提供高度先进的医疗。与医疗保健系统的其他部分一样,专业的院前 EMS 应旨在优化资源利用,并对实践质量进行严格审查和持续评估。本研究旨在全面介绍斯堪的纳维亚国家的院前、医师配备的 EMS。

方法

本研究设计为基于网络的横断面调查。邀请了所有斯堪的纳维亚的专业、医师配备的院前服务,并绘制了 2007 年组织、资格和医疗活动数据。

结果

在受邀的 41 个服务中,有 37 个做出了回应,回应率为 90%(芬兰 86%,瑞典 83%,丹麦 92%,挪威 94%)。组织和教育基本相同。所有服务均提供高级生命支持,且反应时间较短。服务涵盖各种患者群体,不仅需要掌握程序技能,还需要掌握诊断、物流、重症监护和大规模伤亡管理技能。然而,一致和详细的医疗记录往往缺乏。差异主要与时间变量、患者量和服务区域有关。丹麦和瑞典的服务有更高的患者护理量,而芬兰和挪威的服务则提供更多种类的医疗服务。

结论

本调查记录了斯堪的纳维亚院前医师配备的 EMS 系统之间存在的一些显著相似之处。尽管医疗数据登记目前仍不发达,但斯堪的纳维亚医师配备的 EMS 是未来多中心研究的可行领域。

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