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很高比例的院前急救患者并非由救护车运送:芬兰北部的一项回顾性队列研究。

A high proportion of prehospital emergency patients are not transported by ambulance: a retrospective cohort study in Northern Finland.

作者信息

Hoikka M, Silfvast T, Ala-Kokko T I

机构信息

Medical Research Center, Research Group of Surgery, Anesthesia and Intensive Care, University of Oulu, Oulu, Finland.

Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.

出版信息

Acta Anaesthesiol Scand. 2017 May;61(5):549-556. doi: 10.1111/aas.12889.

Abstract

BACKGROUND

The number of missions in the emergency medical services (EMS) has increased considerably in recent years. People are requesting ambulance for even minor illnesses and non-medical problems, which is placing financial and resource burdens on the EMS. The aim of this study was to determine the rate of non-transportation missions in Northern Finland and the reasons for these missions.

METHODS

All ambulance missions in two hospital districts in Northern Finland during the 6-month period of January 1 through June 30, 2014, were retrospectively evaluated from the EMS charts to identify missions in which the patients were not transported by the EMS. The non-transportation rates and reasons were calculated and expressed as percentages.

RESULTS

In 41.7% of the 13,354 missions, the patient was not transported from the scene by an ambulance. After a medical assessment and care was provided by the EMS, 48.2% of these non-transport patients were evaluated as not needing further treatment in the emergency department and were directed to contact the municipal health care center during office hours. There was no need for any medical care in 39.9% of non-transportation missions.

CONCLUSION

This study showed a high rate of EMS missions resulting in non-transportation in two hospital districts in Northern Finland. In the majority of these missions there was no need for emergency admission to an emergency department or for any medical care at all. These findings indicate that an improvement in the dispatch process and primary care resources might be of benefit.

摘要

背景

近年来,紧急医疗服务(EMS)的出诊次数大幅增加。人们即使是 minor illnesses and non-medical problems(轻微疾病和非医疗问题)也请求救护车,这给紧急医疗服务带来了经济和资源负担。本研究的目的是确定芬兰北部非转运任务的发生率及其原因。

方法

对2014年1月1日至6月30日这6个月期间芬兰北部两个医院辖区内的所有救护车出诊任务进行回顾性评估,从紧急医疗服务图表中识别患者未由紧急医疗服务转运的任务。计算非转运率和原因,并以百分比表示。

结果

在13354次出诊任务中,41.7%的患者未由救护车从现场转运。在紧急医疗服务提供医疗评估和护理后,这些非转运患者中有48.2%被评估为不需要在急诊科接受进一步治疗,并被指示在办公时间联系市政医疗保健中心。39.9%的非转运任务不需要任何医疗护理。

结论

本研究表明,芬兰北部两个医院辖区内紧急医疗服务出诊任务导致非转运的发生率很高。在大多数这些任务中,不需要紧急入院到急诊科或根本不需要任何医疗护理。这些发现表明,改进调度流程和初级护理资源可能会有所帮助。

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