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[急诊科创伤与骨科患者的治疗时长]

[Treatment duration of trauma and orthopedic patients in an emergency department].

作者信息

Ruffing T, Danko T, Weiss C, Winkler H, Muhm M

机构信息

Klinik für Unfallchirurgie und Orthopädie 1, Westpfalz-Klinikum GmbH, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Deutschland,

出版信息

Chirurg. 2014 Oct;85(10):904-10. doi: 10.1007/s00104-014-2739-5.

Abstract

INTRODUCTION

The majority of emergency patients are admitted to hospital via the emergency department. Overcrowding in emergency departments results in dissatisfied patients, increased complication rates, and negative medicoeconomic consequences. To overcome these problems, sufficient personnel strength should be available depending on treatment duration and the patients' characteristics.

MATERIALS AND METHODS

First, trauma and orthopedic patients were classified into six categories: ABT (history, findings, and therapy), RABT (X-ray and ABT), WABT (wound care and ABT), WRABT (wound care and RABT), STAT (hospital admission), and SR (trauma life support). Furthermore, the duration of medical treatment was correlated with the physicians' educational level (specialist or physician in training after or during the common trunk period). Not included were waiting periods and nursing care measures. After analyzing the frequency of each category, the mean duration of treatment for an"average patient" was determined.

RESULTS

The duration of treatment of 900 patients was recorded. The average times were 9.5 min (ABT), 13.8 min (RABT), 17.3 min (WABT), 24.5 min (WRABT), 38.4 min (STAT), and 84.2 min (SR). The frequencies for the different categories were: ABT 18.8%; RABT 50.2%; WABT 14.5%; WRABT 4.4%; STAT 10.6%, and SR 1.4%. Thus, an average duration of medical treatment of 17.6 min was calculated. Especially in the RABT category, significant differences between specialists and physicians in training were evident. In children and adolescents, the duration of treatment was 12.5 min.

CONCLUSION

The duration of treatment of an average trauma and orthopedic patient depends on the level of care of the hospital and the qualification of the physician in charge. In order to avoid negative consequences of overcrowding in emergency departments, adequate personnel strength is essential. Personnel strength should be calculated based on the average duration of medical treatment of about 18 min.

摘要

引言

大多数急诊患者通过急诊科入院。急诊科过度拥挤会导致患者不满、并发症发生率增加以及负面的医疗经济后果。为克服这些问题,应根据治疗时长和患者特征配备足够的人力。

材料与方法

首先,将创伤和骨科患者分为六类:ABT(病史、检查结果和治疗)、RABT(X光检查和ABT)、WABT(伤口护理和ABT)、WRABT(伤口护理和RABT)、STAT(住院)和SR(创伤生命支持)。此外,医疗治疗时长与医生的教育水平(专科医生或普通主干阶段之后或期间的住院医师)相关。不包括等待时间和护理措施。在分析每类的频率后,确定了“普通患者”的平均治疗时长。

结果

记录了900名患者的治疗时长。平均时长分别为:ABT 9.5分钟、RABT 13.8分钟、WABT 17.3分钟、WRABT 24.5分钟、STAT 38.4分钟和SR 84.2分钟。不同类别的频率分别为:ABT 18.8%;RABT 50.2%;WABT 14.5%;WRABT 4.4%;STAT 10.6%,SR 1.4%。因此,计算出平均医疗治疗时长为17.6分钟。特别是在RABT类别中,专科医生和住院医师之间存在明显差异。在儿童和青少年中,治疗时长为12.5分钟。

结论

普通创伤和骨科患者的治疗时长取决于医院的护理水平和主管医生的资质。为避免急诊科过度拥挤带来的负面后果,充足的人力至关重要。应根据约18分钟的平均医疗治疗时长来计算人力。

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