Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences.
Acta Med Okayama. 2020 Dec;74(6):513-520. doi: 10.18926/AMO/61210.
Few studies have investigated the influence of the Coronavirus Disease 2019 (COVID-19) pandemic on emer-gency medical service (EMS) systems, especially in areas less affected or unaffected by COVID-19. In this study, we investigated changes in prehospital EMS activity and transport times during the COVID-19 pandemic. All patients transported by EMS in the city of Okayama from March-May 2019 or March-May 2020 were included. Interfacility transports were excluded. The primary outcome was the time from a patient's first emergency call until hospital arrival (total prehospital time). Secondary outcomes included three segments of total prehospital time: the response time, on-scene time, and transportation time. Total prehospital time and the durations of each segment were compared between corresponding months in 2020 (COVID19-affected) and 2019 (control). The results showed that total prehospital times in April 2020 were significantly higher than those in 2019 (33.8 ± 11.6 vs. 32.2 ± 10.8 min, p < 0.001). Increases in total prehospital time were caused by longer response time (9.3 ± 3.8 vs. 8.7 ± 3.7 min, p < 0.001) and on-scene time (14.4 ± 7.9 vs. 13.5 ± 6.2min, p < 0.001). The COVID-19 pandemic was thus shown to affect EMS and delayed arrival/response even in a minimally affected region. A system to minimize transportation delays should be developed for emerging pandemics.
很少有研究调查 2019 年冠状病毒病（COVID-19）大流行对急诊医疗服务（EMS）系统的影响，特别是在受 COVID-19 影响较小或未受影响的地区。在这项研究中，我们调查了 COVID-19 大流行期间院前 EMS 活动和转运时间的变化。纳入了 2019 年 3 月至 5 月或 2020 年 3 月至 5 月期间在冈山市由 EMS 转运的所有患者。排除了院内转运。主要结局是从患者第一次紧急呼救到医院到达的时间（总院前时间）。次要结局包括总院前时间的三个部分：反应时间、现场时间和转运时间。比较了 2020 年（COVID19 流行）和 2019 年（对照）同期相应月份的总院前时间和各部分的持续时间。结果表明，2020 年 4 月的总院前时间明显长于 2019 年（33.8 ± 11.6 比 32.2 ± 10.8 分钟，p < 0.001）。总院前时间的增加是由于反应时间（9.3 ± 3.8 比 8.7 ± 3.7 分钟，p < 0.001）和现场时间（14.4 ± 7.9 比 13.5 ± 6.2 分钟，p < 0.001）的延长所致。因此，即使在受影响较小的地区，COVID-19 大流行也会影响 EMS 并延迟到达/反应。应开发一种系统来最小化运输延误，以应对新出现的大流行。
