Pointer J E, Osur M A
City and County of San Francisco EMS, California 94102.
Ann Emerg Med. 1989 Oct;18(10):1119-21. doi: 10.1016/s0196-0644(89)80944-8.
Because of discontinuation of base hospital participation, paramedics in a large urban zone of a California emergency medical services (EMS) system serving 1.1 million persons went on emergency standing orders for nearly all calls requiring advanced life support. Subsequently, the base hospital resumed medical control function under limited standing orders. Standing orders were allowed for calls that required rapid intervention with little probability of morbidity. The EMS agency conducted a retrospective study to compare times at scene and total prehospital care times before (control group) and after institution of standing orders and limited standing orders. There were significant differences in total prehospital care times and at-scene times between the control group and the two standing order groups (P less than .01). There are important implications to EMS systems that use extensive base hospital contact.
由于基地医院不再参与，在加利福尼亚州一个为110万人服务的紧急医疗服务（EMS）系统的大型城区，护理人员几乎对所有需要高级生命支持的呼叫都采用了紧急常备医嘱。随后，基地医院在有限的常备医嘱下恢复了医疗控制功能。对于那些需要迅速干预且发病可能性较小的呼叫允许采用常备医嘱。该EMS机构进行了一项回顾性研究，以比较常备医嘱和有限常备医嘱实施之前（对照组）与之后的现场时间和院前总护理时间。对照组与两个常备医嘱组之间的院前总护理时间和现场时间存在显著差异（P小于0.01）。这对大量依赖基地医院联系的EMS系统具有重要意义。
