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从大型集会活动中出现的患者对事件中、救护车和急诊科服务的影响:回顾性分析。

Impacts on in-event, ambulance and emergency department services from patients presenting from a mass gathering event: A retrospective analysis.

机构信息

Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia.

Department of Emergency Medicine, Gold Coast Health, Gold Coast, Queensland, Australia.

出版信息

Emerg Med Australas. 2019 Jun;31(3):423-428. doi: 10.1111/1742-6723.13194. Epub 2018 Nov 8.

Abstract

OBJECTIVE

The aim of this study was to describe the in-event, ambulance and ED impacts of patient presentations from an Australian mass gathering event (MGE) including patient demographics, provision of care, length of stay and discharge disposition.

METHODS

This research was set at one MGE in Australia. The MGE had one first aid post and one in-event health team staffed by doctors, nurses and paramedics. A retrospective analysis of patient care records from providers of in-event, ambulance and ED services was undertaken. Data analysis included descriptive and inferential statistics.

RESULTS

Of the 20 000 MGE participants, 197 (0.99% [95% CI 0.86-1.13], 9.85/1000) presented for in-event first aid care, with 24/197 (12.2% [95% CI 8.33-17.49], 1.2/1000) referred to in-event health professionals. Fifteen of the referred patients (62.5% [95% CI 42.71-78.84]) returned to the MGE following administration of intravenous fluids (n = 13) and/or anti-emetics (n = 11). Seven (29.2% [95% CI 14.92-49.17], 0.35/1000) were referred to ambulance paramedic care, requiring endotracheal intubation (n = 1) and airway adjuncts (n = 3) prior to transportation to ED; these patients had an ED median length of stay of 7 h (5.5-12.5) receiving imaging and ventilator support. Five were discharged from ED, one required an operation and another required intensive care unit admission.

CONCLUSIONS

There was an impact on in-event, ambulance and ED services from this MGE but the in-event model of care may have limited ambulance usage and ED visits. The ED length of stay was greater than the national median, perhaps reflecting the appropriateness of transport and nature of care requirements while in the ED.

摘要

目的

本研究旨在描述澳大利亚大型集会活动(MGE)中患者就诊的事件内、救护车和急诊部影响,包括患者人口统计学特征、提供的护理、住院时间和出院去向。

方法

本研究在澳大利亚的一个 MGE 现场进行。该 MGE 设有一个急救站和一个由医生、护士和护理人员组成的现场急救医疗团队。对现场急救、救护车和 ED 服务提供者的患者护理记录进行回顾性分析。数据分析包括描述性和推断性统计。

结果

在 20000 名 MGE 参与者中,有 197 人(0.99%[95%CI 0.86-1.13],9.85/1000)接受了现场急救护理,其中 24 人(12.2%[95%CI 8.33-17.49],1.2/1000)被转介给现场急救医疗专业人员。在给予静脉补液(n=13)和/或止吐药(n=11)后,15 名转介患者(62.5%[95%CI 42.71-78.84])返回 MGE。7 人(29.2%[95%CI 14.92-49.17],0.35/1000)被转介至救护车护理,在送往 ED 之前需要进行气管插管(n=1)和气道辅助治疗(n=3);这些患者在 ED 的中位住院时间为 7 小时(5.5-12.5),接受了影像学和呼吸机支持。5 人从 ED 出院,1 人需要手术,1 人需要重症监护病房住院治疗。

结论

MGE 对现场急救、救护车和 ED 服务产生了影响,但现场急救模式可能限制了救护车的使用和 ED 就诊。ED 住院时间长于全国中位数,这可能反映了在 ED 转运和护理需求的适当性。

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