急症外科：急症外科服务对急诊科评估、流程和处置的影响。
Acute care surgery: the impact of an acute care surgery service on assessment, flow, and disposition in the emergency department.
机构信息
Department of Surgery, Foothills Medical Centre, 1403 29 Street NW, Calgary, Alberta, Canada T2N 2T9.
Department of Surgery, Foothills Medical Centre, 1403 29 Street NW, Calgary, Alberta, Canada T2N 2T9.
出版信息
Am J Surg. 2012 May;203(5):578-583. doi: 10.1016/j.amjsurg.2011.12.006. Epub 2012 Mar 7.
BACKGROUND
Acute care surgery (ACS) services are becoming increasingly popular.
METHODS
Assessment, flow, and disposition of adult ACS patients (acute, nontrauma surgical conditions) through the emergency department (ED) in a large health care system (Calgary) were prospectively analyzed.
RESULTS
Among 447 ACS ED consultations over 3 centers (70% admitted to ACS), the median wait time from the consultation request to ACS arrival was 36 minutes, and from ACS arrival to the admission request it was 91 minutes. The total ACS-dependent time was 127 minutes compared with 261 minutes for initial ED activities and 104 minutes for transfer to a hospital ward (P < .05). Forty percent of patients underwent computed tomography (CT) imaging (76% before consultation). The time to ACS consultation was 305 minutes when a CT scan was performed first.
CONCLUSIONS
An ACS service results in rapid ED assessment of surgical emergencies. Patient waiting is dominated by the time before requesting ACS consultation and/or waiting for transfer to the ward.
背景
急性护理外科（ACS）服务越来越受欢迎。
方法
在一个大型医疗保健系统（卡尔加里）中，通过急诊室（ED）对成人 ACS 患者（急性、非创伤性外科疾病）进行评估、流程和处置。
结果
在 3 个中心的 447 次 ACS ED 会诊中（70%的患者被收入 ACS），从会诊请求到 ACS 到达的中位等待时间为 36 分钟，从 ACS 到达到入院请求的中位等待时间为 91 分钟。ACS 相关时间为 127 分钟，而初始 ED 活动时间为 261 分钟，转到医院病房时间为 104 分钟（P<.05）。40%的患者接受了计算机断层扫描（CT）成像（76%在会诊前）。当首先进行 CT 扫描时，ACS 会诊的时间为 305 分钟。
结论
ACS 服务可快速对急诊外科急症进行评估。患者等待时间主要由请求 ACS 会诊之前的时间和/或等待转入病房的时间决定。
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