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移动无线监测系统在院前急救中的应用。

Mobile wireless monitoring system for prehospital emergency care.

机构信息

Faculty of Computer Science, University "Goce Delchev"-Stip, Stip, Macedonia.

General Hospital Celje, Celje, Slovenia.

出版信息

Eur J Trauma Emerg Surg. 2020 Dec;46(6):1301-1308. doi: 10.1007/s00068-019-01130-4. Epub 2019 Apr 5.

DOI:10.1007/s00068-019-01130-4
PMID:30953110
Abstract

BACKGROUND

Latest achievement technologies allow engineers to develop medical systems that medical doctors in the health care system could not imagine years ago. The development of signal theory, intelligent systems, biophysics and extensive collaboration between science and technology researchers and medical professionals, open up the potential for preventive, real-time monitoring of patients. With the recent developments of new methods in medicine, it is also possible to predict the trends of the disease development as well the systemic support in diagnose setting. Within the framework of the needs to track the patient health parameters in the hospital environment or in the case of road accidents, the researchers had to integrate the knowledge and experiences of medical specialists in emergency medicine who have participated in the development of a mobile wireless monitoring system designed for real-time monitoring of victim vital parameters. Emergency medicine responders are first point of care for trauma victim providing prehospital care, including triage and treatment at the scene of incident and transport from the scene to the hospital. Continuous monitoring of life functions allows immediate detection of a deterioration in health status and helps out in carrying out principle of continuous e-triage. In this study, a mobile wireless monitoring system for measuring and recording the vital parameters of the patient was presented and evaluated. Based on the measured values, the system is able to make triage and assign treatment priority for the patient. The system also provides the opportunity to take a picture of the injury, mark the injured body parts, calculate Glasgow Coma Score, or insert/record the medication given to the patient. Evaluation of the system was made using the Technology Acceptance Model (TAM). In particular we measured: perceived usefulness, perceived ease of use, attitude, intention to use, patient status and environmental status.

METHODS

A functional prototype of a developed wireless sensor-based system was installed at the emergency medical (EM) department, and presented to the participants of this study. Thirty participants, paramedics and doctors from the emergency department participated in the study. Two scenarios common for the prehospital emergency routines were considered for the evaluation. Participants were asked to answer the questions referred to these scenarios by rating each of the items on a 5-point Likert scale.

RESULTS

Path coefficients between each measured variable were calculated. All coefficients were positive, but the statistically significant were only the following: patient status and perceive usefulness (β = 0.284, t = 2.097), environment (both urban a nd rural) and perceive usefulness (β = 0.247, t = 2.570; β = 0.329, t = 2.083, respectively), and perceive usefulness and behavioral intention (β = 0.621 t = 7.269). The variance of intention is 47.9%.

CONCLUSIONS

The study results show that the proposed system is well accepted by the EM personnel and can be used as a complementary system in EM department for continuous monitoring of patients' vital signs.

摘要

背景

最新的技术成就使工程师能够开发出医疗系统,而这些系统是医疗系统中的医生多年前无法想象的。信号理论、智能系统、生物物理学以及科技研究人员与医学专业人员之间的广泛合作,为患者的预防性、实时监测开辟了潜力。随着医学新方法的最新发展,也有可能预测疾病发展的趋势以及诊断设置中的系统支持。在需要跟踪医院环境中患者健康参数或发生道路事故的情况下,研究人员必须整合参与开发专为实时监测受害者生命参数而设计的移动无线监测系统的急诊医学专家的知识和经验。急救医学响应者是创伤受害者的第一护理点,提供院前护理,包括在事件现场进行分诊和治疗,并将患者从现场转运到医院。对生命功能的持续监测可以立即发现健康状况的恶化,并有助于实施连续电子分诊的原则。在这项研究中,提出并评估了用于测量和记录患者生命参数的移动无线监测系统。基于测量值,系统能够对患者进行分诊并分配治疗优先级。该系统还提供了拍摄伤害照片、标记受伤身体部位、计算格拉斯哥昏迷评分或插入/记录给患者的药物的机会。使用技术接受模型 (TAM) 对系统进行了评估。特别是,我们测量了:感知有用性、感知易用性、态度、使用意图、患者状况和环境状况。

方法

在急诊医学 (EM) 部门安装了开发的基于无线传感器的系统的功能原型,并向该研究的参与者展示。来自急诊部的 30 名参与者,包括护理人员和医生,参加了这项研究。考虑了两种常见的院前急救常规场景进行评估。参与者被要求通过对 5 分李克特量表上的每个项目进行评分来回答这些场景的问题。

结果

计算了每个测量变量之间的路径系数。所有系数均为正,但统计学上显著的只有以下:患者状况和感知有用性(β=0.284,t=2.097)、环境(城市和农村)和感知有用性(β=0.247,t=2.570;β=0.329,t=2.083),以及感知有用性和行为意图(β=0.621,t=7.269)。意图的方差为 47.9%。

结论

研究结果表明,该系统得到了急诊医学人员的广泛认可,可以作为急诊部的补充系统,用于对患者生命体征进行连续监测。

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