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节省院外心脏骤停患者的现场时间:注册护士在紧急医疗服务团队中的角色与表现

Saving the On-Scene Time for Out-of-Hospital Cardiac Arrest Patients: The Registered Nurses' Role and Performance in Emergency Medical Service Teams.

作者信息

Lin Ming-Wei, Wu Che-Yu, Pan Chih-Long, Tian Zhong, Wen Jyh-Horng, Wen Jet-Chau

机构信息

Graduate School of Engineering Science and Technology, National Yunlin University of Science & Technology, 123 Section 3, University Road, Douliou, Yunlin 640, Taiwan.

ChangHua Fire Bureau, 1 Zhongyang Road, Changhua, Changhua 500, Taiwan.

出版信息

Biomed Res Int. 2017;2017:5326962. doi: 10.1155/2017/5326962. Epub 2017 Feb 9.

Abstract

For out-of-hospital cardiac arrest (OHCA) patients, every second is vital for their life. Shortening the prehospital time is a challenge to emergency medical service (EMS) experts. This study focuses on the on-scene time evaluation of the registered nurses (RNs) participating in already existing EMS teams, in order to explore their role and performance in different EMS cases. In total, 1247 cases were separated into trauma and nontrauma cases. The nontrauma cases were subcategorized into OHCA (NT-O), critical (NT-C), and noncritical (NT-NC) cases, whereas the trauma cases were subcategorized into collar-and-spinal board fixation (T-CS), fracture fixation (T-F), and general trauma (T-G) cases. The average on-scene time of RN-attended cases showed a decrease of 21.05% in NT-O, 3.28% in NT-C, 0% in NT-NC, 18.44% in T-CS, 13.56% in T-F, and 3.46% in T-G compared to non-RN-attended. In NT-O and T-CS cases, the RNs' attendance can notably save the on-scene time with a statistical significance ( = .016 and .017, resp.). Furthermore, the return of spontaneous circulation within two hours (ROSC) rate in the NT-O cases was increased by 12.86%. Based on the findings, the role of RNs in the EMTs could save the golden time in the prehospital medical care in Taiwan.

摘要

对于院外心脏骤停(OHCA)患者而言,每一秒对其生命都至关重要。缩短院前时间是急救医疗服务(EMS)专家面临的一项挑战。本研究聚焦于参与现有EMS团队的注册护士(RN)的现场时间评估,以探究他们在不同EMS病例中的作用和表现。总共1247例病例被分为创伤和非创伤病例。非创伤病例又细分为OHCA(NT - O)、危急(NT - C)和非危急(NT - NC)病例,而创伤病例则细分为颈托和脊柱板固定(T - CS)、骨折固定(T - F)和一般创伤(T - G)病例。与无RN参与的病例相比,RN参与的病例的平均现场时间在NT - O中减少了21.05%,在NT - C中减少了3.28%,在NT - NC中减少了0%,在T - CS中减少了18.44%,在T - F中减少了13.56%,在T - G中减少了3.46%。在NT - O和T - CS病例中,RN的参与能显著节省现场时间,具有统计学意义(分别为 =.016和.017)。此外,NT - O病例中两小时内自主循环恢复(ROSC)率提高了12.86%。基于这些发现,RN在急救医疗技术人员中的作用可以在台湾的院前医疗中节省黄金时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a7/5322439/ca46448d0770/BMRI2017-5326962.001.jpg

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