在院前急救护理中使用机动救护车的创新。
Innovation in the use of motor ambulance for prehospital emergency care.
作者信息
Jafari Mehdi, Shakeri Khosro, Mahmoudian Payam, Bathaei Seyed Ahmad
机构信息
Department of Health Service Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.
出版信息
J Educ Health Promot. 2019 Feb 15;8:38. doi: 10.4103/jehp.jehp_249_18. eCollection 2019.
BACKGROUND
Prehospital emergency care system is one of the important parts of the health system. Heavy traffic, increasing urban population, and growing demands for prehospital emergency services are challenges faced by this section of the health system. One of the approaches to deal with this issue is using motor ambulances.
AIMS
This study aims to investigate the missions of motor ambulances, ambulances, and the effects of motor ambulance services on response time and ambulance missions.
MATERIALS AND METHODS
This applied research has been designed as a descriptive and cross-sectional study. Overall, 267,836 missions carried out by ambulances and motor ambulances of Tehran emergency medical service (EMS) Center in the years 2014 and 2015 were investigated. The data were gathered personally by visiting Tehran EMS Center. The data were analyzed by Excel (2013) software.
RESULTS
The average response time for ambulances and motor ambulances were 16 min and 14 min and 13 s, respectively. Most of the ambulance and motor ambulance missions were reportedly due to weakness (20%) and heart problems (16%). In 57% of ambulance missions and 71.5% of motor ambulance missions, the patients refused to being transferred to the hospital. Most of the transport missions to hospital (24%) were caused by traffic accidents.
CONCLUSIONS
According to the results, the response time was higher than the national standards. Locating motor ambulances on the streets and outside emergency stations during peak traffic times decreased the response time by 2 min and by providing the necessary services in the scene and transferring fewer patients to the hospital, it is possible to provide further services by assigning ambulances to more urgent missions. Thus, it is recommended to employ more seasoned staff, multiply motor ambulances, and locate motor ambulances precisely to decrease response time and also at a lower cost more citizens are provided with prehospital care.
背景
院前急救系统是卫生系统的重要组成部分之一。交通拥堵、城市人口增加以及对院前急救服务需求的不断增长是该卫生系统面临的挑战。应对这一问题的方法之一是使用机动救护车。
目的
本研究旨在调查机动救护车的任务、救护车的任务以及机动救护车服务对响应时间和救护车任务的影响。
材料与方法
本应用研究设计为描述性横断面研究。总体上，对德黑兰紧急医疗服务（EMS）中心在2014年和2015年由救护车和机动救护车执行的267836次任务进行了调查。数据通过走访德黑兰EMS中心亲自收集。数据使用Excel（2013）软件进行分析。
结果
救护车和机动救护车的平均响应时间分别为16分钟和14分13秒。据报道，大多数救护车和机动救护车任务是由于身体虚弱（20%）和心脏问题（16%）。在57%的救护车任务和71.5%的机动救护车任务中，患者拒绝转院。大多数送往医院的运输任务（24%）是由交通事故引起的。
结论
根据结果，响应时间高于国家标准。在交通高峰时段将机动救护车部署在街道和急救站外可将响应时间缩短2分钟，并且通过在现场提供必要服务并减少送往医院的患者数量，有可能通过将救护车分配给更紧急的任务来提供更多服务。因此，建议雇佣更有经验的工作人员、增加机动救护车数量并精确部署机动救护车，以缩短响应时间，同时以更低成本为更多市民提供院前护理。
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