National Centre for Emergency Primary Health Care, Uni Health, Bergen, Norway, Kalfarveien 31, 5018 Bergen, Norway.
Scand J Trauma Resusc Emerg Med. 2010 Feb 18;18:9. doi: 10.1186/1757-7241-18-9.
There is a lack of epidemiological knowledge on medical emergencies outside hospitals in Norway. The aim of the present study was to obtain representative data on the epidemiology of medical emergencies classified as "red responses" in Norway.
Three emergency medical dispatch centres (EMCCs) were chosen as catchment areas, covering 816 000 inhabitants. During a three month period in 2007 the EMCCs gathered information on every situation that was triaged as a red response, according to The Norwegian Index of Medical Emergencies (Index). Records from ground ambulances, air ambulances, and the primary care doctors were subsequently collected. International Classification of Primary Care-2 symptom codes (ICPC-2) and The National Committee on Aeronautics (NACA) Score System were given retrospectively.
Total incidence of red response situations was 5 105 during the three month period. 394 patients were involved in 138 accidents, and 181 situations were without patients, resulting in a total of 5 180 patients. The patients' age ranged from 0 to 107 years, with a median age of 57, and 55% were male. 90% of the red responses were medical problems with a large variation of symptoms, the remainder being accidents. 70% of the patients were in a non-life-threatening situation. Within the accident group, males accounted for 61%, and 35% were aged between 10 and 29 years, with a median age of 37 years. Few of the 39 chapters in the Index were used, A10 "Chest pain" was the most common one (22% of all situations). ICPC-2 symptom codes showed that cardiovascular, syncope/coma, respiratory and neurological problems were most common. 50% of all patients in a sever situation (NACA score 4-7) were > 70 years of age.
The results show that emergency medicine based on 816 000 Norwegians mainly consists of medical problems, where the majority of the patients have a non-life-threatening situation. More focus on the emergency system outside hospitals, including triage and dispatch, and how to best deal with "everyday" emergency problems is needed to secure knowledge based decisions for the future organization of the emergency system.
挪威缺乏有关医院外医疗急救的流行病学知识。本研究的目的是获得挪威“红色反应”医疗急救分类的代表性流行病学数据。
选择三个紧急医疗调度中心（EMCC）作为集水区，覆盖 816000 名居民。在 2007 年的三个月期间，EMCC 根据挪威医疗急救索引（Index）对每个被归类为红色反应的情况进行了分类。随后收集了地面救护车、空中救护车和初级保健医生的记录。回顾性地使用了初级保健国际分类-2 症状代码（ICPC-2）和国家航空咨询委员会（NACA）评分系统。
在三个月期间，红色反应情况的总发生率为 5105 例。有 394 名患者参与了 138 起事故，181 起情况无患者，共计 5180 名患者。患者年龄从 0 岁到 107 岁不等，中位数为 57 岁，男性占 55%。90%的红色反应是医疗问题，症状差异很大，其余为事故。70%的患者情况没有生命危险。在事故组中，男性占 61%，年龄在 10 至 29 岁之间的占 35%，中位数年龄为 37 岁。索引的 39 个章节中很少使用，A10“胸痛”是最常见的一个（占所有情况的 22%）。ICPC-2 症状代码显示，心血管、晕厥/昏迷、呼吸和神经问题最常见。50%的严重情况（NACA 评分 4-7）患者年龄大于 70 岁。
结果表明，以 816000 名挪威人为基础的急诊医学主要由医疗问题组成，其中大多数患者的情况没有生命危险。需要更加关注医院外的急救系统，包括分诊和调度，以及如何最好地处理“日常”急救问题，以确保未来组织急救系统的决策基于知识。
