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大规模伤亡事件并发时急诊患者的院前反应时间延迟

Prehospital Response Time Delays for Emergency Patients in Events of Concurrent Mass Casualty Incidents.

作者信息

Kim Jungeun, Kim Chu Hyun, Shin Sang Do, Park Ju Ok

机构信息

1Laboratory of Emergency Medical Services,Seoul National University Hospital Biomedical Research Institute,Seoul,Korea.

2Department of Emergency Medicine,Inje University College of Medicine and Seoul Paik Hospital,Seoul,Korea.

出版信息

Disaster Med Public Health Prep. 2018 Feb;12(1):94-100. doi: 10.1017/dmp.2017.42. Epub 2017 Sep 19.

DOI:10.1017/dmp.2017.42
PMID:28925344
Abstract

OBJECTIVE

We investigated the extent of delays in the response time of emergency medical services (EMS) as an impact of mass casualty incidences (MCIs) in the same area.

METHODS

We defined an MCI case as an event that resulted in 6 or more patients being transported by EMS, and prehospital response time as the time from the call to arrival at the scene. We matched patients before and after MCIs by dividing them into categories of 3 hours before, 0-1 hour after, 1-2 hours after, and 2-3 hours after the MCIs. We compared prehospital response times using multiple linear regression.

RESULTS

A total of 33,276 EMS-treated patients were matched. The prehospital response time for the category of 3 hours before the MCIs was 8.8 minutes (SD: 8.2), treated as the reference, whereas that for the category of 0-1 hour after the MCI was 11.3 minutes (P<0.01). The multiple linear regression analysis revealed that prehospital response time increased by 2.5 minutes (95% CI: 2.3-2.8) during the first hour and by 0.3 minutes (95% CI: 0.1-0.6) during the second hour after MCIs.

CONCLUSION

There were significant delays in the prehospital response time for emergency patients after MCIs, and it lasted for 2 hours as the spillover effect. (Disaster Med Public Health Preparedness. 2018;12:94-100).

摘要

目的

我们调查了紧急医疗服务(EMS)响应时间的延迟程度,这是同一地区大规模伤亡事件(MCI)造成的影响。

方法

我们将MCI病例定义为导致6名或更多患者由EMS转运的事件,并将院前响应时间定义为从呼叫到到达现场的时间。我们通过将MCI前后的患者分为MCI前3小时、MCI后0 - 1小时、MCI后1 - 2小时和MCI后2 - 3小时这几类来进行匹配。我们使用多元线性回归比较院前响应时间。

结果

总共匹配了33276名接受EMS治疗的患者。将MCI前3小时这一类别的院前响应时间8.8分钟(标准差:8.2)作为参考,而MCI后0 - 1小时这一类别的院前响应时间为11.3分钟(P<0.01)。多元线性回归分析显示,MCI后第一小时内院前响应时间增加了2.5分钟(95%置信区间:2.3 - 2.8),第二小时内增加了0.3分钟(95%置信区间:0.1 - 0.6)。

结论

MCI后急诊患者的院前响应时间出现了显著延迟,并且作为溢出效应持续了2小时。(《灾难医学与公共卫生防范》。2018年;12:94 - 100)

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