Mort Alasdair J, Rushworth Gordon F
The Centre for Rural Health, University of Aberdeen, Old Perth Road, Inverness, IV2 3JH, Scotland, UK,
J Clin Monit Comput. 2013 Dec;27(6):599-607. doi: 10.1007/s10877-013-9475-0. Epub 2013 May 26.
To gather preferences for novel pre-hospital physiologic monitoring technologies from emergency rescue services. Qualitative semi-structured interviews and focus groups were conducted with three groups from UK Search and Rescue (SAR); (1) Extractors (e.g. SAR teams), (2) Transporters (personnel primarily responsible for casualty transport), and (3) Treaters (e.g. Emergency Department doctors). Three themes were defined; SAR casualty management, novel physiologic monitor potential, and physiologic monitor physical properties. Some SAR groups already employed physiologic monitoring but there was no consensus on which monitor(s) to carry or what to monitor and how frequently. Existing monitors also tended to be bulky and heavy and could be unreliable in an unstable environment or if the casualty was cold. Those performing monitoring tended to have only basic first-aid training, and their workload was often high particularly if there was more than one casualty. The potential benefits of employing a novel monitor were strategic and clinical; an opportunity for transmitting data off-scene in order to facilitate monitoring or generate advice (i.e. telemedicine) was also voiced. A range of more intuitive, physical properties was also raised (e.g. small/compact, lightweight). SAR-specific technology should be simple to operate by those with less medical training, which means that clinical data interpretation and presentation should be carefully considered. It would be beneficial if novel monitors carried out a majority of the interpretation, allowing rescuers to proceed with their priority task of removing the casualty to safety.
收集紧急救援服务部门对新型院前生理监测技术的偏好。对来自英国搜救(SAR)的三个群体进行了定性半结构化访谈和焦点小组讨论;(1)救援人员(如搜救队),(2)运输人员(主要负责伤员运输的人员),以及(3)治疗人员(如急诊科医生)。确定了三个主题;SAR伤员管理、新型生理监测仪的潜力以及生理监测仪的物理特性。一些SAR群体已经采用了生理监测,但对于携带哪种监测仪、监测什么以及监测频率没有达成共识。现有的监测仪往往体积庞大、重量较重,在不稳定环境中或伤员体温过低时可能不可靠。进行监测的人员往往只接受过基本的急救培训,而且他们的工作量通常很大,特别是在有多名伤员的情况下。采用新型监测仪的潜在好处具有战略意义和临床意义;还提到了一个在现场外传输数据以方便监测或生成建议(即远程医疗)的机会。还提出了一系列更直观的物理特性(如小型/紧凑、轻便)。特定于SAR的技术应该便于接受较少医学培训的人员操作,这意味着应该仔细考虑临床数据的解读和呈现。如果新型监测仪能够进行大部分解读,使救援人员能够继续执行将伤员转移到安全地带这一优先任务,那将是有益的。