Department of Emergency Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Prehosp Disaster Med. 2012 Apr;27(2):123-9. doi: 10.1017/S1049023X12000416. Epub 2012 May 17.
Quantitative benchmarking of trauma-related prehospital response for Multiple Casualty Events (MCE) is complicated by major difficulties due to the simultaneous occurrences of multiple prehospital activities.
HYPOTHESIS/PROBLEM: Attempts to quantify the various components of prehospital medical response in MCE have fallen short of a comprehensive model. The objective of this study was to model the principal parameters necessary to quantitatively benchmark the prehospital medical response in trauma-related MCE.
A two-step approach was adopted for the methodology of this study: an extensive literature search was performed, followed by prehospital system quantitative modeling. Studies on prehospital medical response to trauma injuries were used as the framework for the proposed model. The North Atlantic Treaty Organization (NATO) triage categories (T1-T4) were used for the study.
Two parameters, the Injury to Patient Contact Interval (IPCI) and Injury to Hospital Interval (IHI), were identified and proposed as the principal determinants of the medical prehospital response in trauma-related MCE. IHI is the time interval from the occurrence of injury to the completion of transfer of care of critical (T1) and moderate (T2) patients. The IHI for each casualty is compared to the Maximum Time Allowed described in the literature (golden hour for T1 and Friedrich's time for T2). In addition, the medical rescue factor (R) was identified as the overall indicator for the prehospital medical performance for T1 and T2, and a numerical value of one (R = 1) was proposed to be the quantitative benchmark.
A new quantitative model for benchmarking prehospital response to MCE in trauma-related MCE is proposed. Prospective studies of this model are needed to validate its applicability.
由于多个院前活动同时发生，对多发伤事件（MCE）相关创伤前医疗反应进行定量基准测试存在很大困难。
假设/问题：试图对 MCE 中各种院前医疗反应进行量化的尝试都未能建立一个全面的模型。本研究的目的是建立一个模型，以定量基准测试与创伤相关的 MCE 中的院前医疗反应的主要参数。
本研究采用两步法进行方法学研究：进行广泛的文献检索，然后进行院前系统定量建模。创伤后院前医疗反应的研究被用作拟议模型的框架。北约分类（T1-T4）用于该研究。
确定了两个参数，即从患者受伤到与医院接触的时间间隔（IPCI）和从受伤到完成对危急（T1）和中度（T2）患者的治疗的时间间隔（IHI），并将其作为创伤相关 MCE 中院前医疗反应的主要决定因素。IHI 是从受伤发生到完成对危急（T1）和中度（T2）患者的治疗的时间间隔。每个伤员的 IHI 与文献中描述的最大允许时间（T1 的黄金时间和 T2 的 Friedrich 时间）进行比较。此外，确定医疗救援因子（R）为 T1 和 T2 院前医疗表现的整体指标，建议数值为 1（R=1）作为定量基准。
提出了一种用于创伤相关 MCE 中多发伤事件院前反应的新的定量模型。需要对该模型进行前瞻性研究，以验证其适用性。
