Igarashi Yutaka, Yokobori Shoji, Yamana Hidetoshi, Nagakura Kosuke, Hagiwara Jun, Masuno Tomohiko, Yokota Hiroyuki
Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan.
Emergency Department Tsukuba Medical Center Hospital Tsukuba Japan.
Acute Med Surg. 2018 Jun 4;5(4):316-320. doi: 10.1002/ams2.347. eCollection 2018 Oct.
In Japan, standard prehospital care is provided by emergency medical services teams. Doctor-staffed ambulances play a role in facilitating the immediate treatment of critically ill patients to increase the survival rates. However, little is known about their activities. We revealed the present situation of doctor-staffed ambulances in Japan.
First, we surveyed all the fire departments in Japan and determined whether a doctor-staffed ambulance was present within their district boundary. Second, we surveyed hospitals that operate doctor-staffed ambulances in their system to list their activities during a 1-week period.
Of 133 hospitals that operated a doctor-staffed ambulance, 73 (55%) replied to our questionnaire. Only 26 (36%) of them provided 24-h ambulance deployment. Additionally, 51 (70%) of hospitals bore the operational costs of ambulances. Within 1 week, 345 doctor-staffed ambulances were dispatched, but 97 (28%) were cancelled. In total, 62 patients (28%) were diagnosed with cardiac arrest, 48 (19%) with trauma or burns, 36 (15%) with stroke, and 22 (9%) with acute coronary syndrome; 159 (58%) were transferred to a tertiary emergency medical center.
Doctor-staffed ambulances have the advantage of deployment at night and in urban areas compared to doctor-staffed helicopters. Among the 73 hospitals that responded to the questionnaire, doctor-staffed ambulances were dispatched almost as frequently as doctor-staffed helicopters. However, doctor-staffed ambulances did not receive adequate funding. Future data collection is necessary to determine the efficacy of doctor-staffed ambulances among hospitals that operate this service.
在日本，院前急救由紧急医疗服务团队提供。配备医生的救护车在促进对危重症患者的即时治疗以提高生存率方面发挥着作用。然而，人们对其活动了解甚少。我们揭示了日本配备医生的救护车的现状。
首先，我们对日本所有的消防部门进行了调查，确定其辖区范围内是否有配备医生的救护车。其次，我们对在其系统中运营配备医生救护车的医院进行了调查，列出了它们在1周内的活动情况。
在133家运营配备医生救护车的医院中，73家（55%）回复了我们的问卷。其中只有26家（36%）提供24小时救护车调度服务。此外，51家（70%）医院承担救护车的运营成本。在1周内，共调度了345辆配备医生的救护车，但有97辆（28%）被取消。总共有62名患者（28%）被诊断为心脏骤停，48名（19%）为创伤或烧伤，36名（15%）为中风，22名（9%）为急性冠状动脉综合征；159名（58%）被转至三级紧急医疗中心。
与配备医生的直升机相比，配备医生的救护车在夜间和城市地区的调度方面具有优势。在回复问卷的73家医院中，配备医生的救护车的调度频率几乎与配备医生的直升机相同。然而，配备医生的救护车没有获得足够的资金。未来有必要收集数据，以确定配备医生的救护车在提供此项服务的医院中的疗效。
