Department of Emergency Medicine, SUNY Upstate Medical University, Syracuse, New York, USA.
Prehosp Emerg Care. 2011 Oct-Dec;15(4):555-61. doi: 10.3109/10903127.2011.608871.
The emergency medical services (EMS) system is a component of a larger health care safety net and a key component of an integrated emergency health care system. EMS systems, and their patients, are significantly impacted by emergency department (ED) crowding. While protocols designed to limit ambulance diversion may be effective at limiting time on divert status, without correcting overall hospital throughput these protocols may have a negative effect on ED crowding and the EMS system. Ambulance offload delay, the time it takes to transfer a patient to an ED stretcher and for the ED staff to assume the responsibility of the care of the patient, may have more impact on ambulance turnaround time than ambulance diversion. EMS administrators and medical directors should work with hospital administrators, ED staff, and ED administrators to improve the overall efficiency of the system, focusing on the time it takes to get ambulances back into service, and therefore must monitor and address both ambulance diversions and ambulance offload delay. This paper is the resource document for the National Association of EMS Physicians position statement on ambulance diversion and ED offload time. Key words: ambulance; EMS; diversion; bypass; offload; delay.
紧急医疗服务（EMS）系统是更大的医疗保健安全网的一个组成部分，也是综合紧急医疗保健系统的一个关键组成部分。EMS 系统及其患者受到急诊部（ED）拥堵的显著影响。虽然旨在限制救护车分流的协议可能在限制转移状态的时间方面有效，但如果不纠正整体医院吞吐量，这些协议可能对 ED 拥堵和 EMS 系统产生负面影响。救护车卸载延迟，即从救护车转移患者到 ED 担架上，以及 ED 工作人员承担患者护理责任的时间，可能比救护车分流对救护车周转时间的影响更大。EMS 管理员和医疗主任应与医院管理员、ED 工作人员和 ED 管理员合作，提高系统的整体效率，重点关注让救护车重新投入使用所需的时间，因此必须监测和解决救护车分流和救护车卸载延迟的问题。本文是国家 EMS 医师协会关于救护车分流和 ED 卸载时间的立场声明的资源文件。关键词：救护车；EMS；转移；旁路；卸载；延迟。
