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探讨 COVID-19 期间创伤患者的急诊医疗服务院前转运时间。

Examining emergency medical services' prehospital transport times for trauma patients during COVID-19.

机构信息

ION Research, 501 East Hampden Ave, Englewood, CO 80113, United States of America.

Wesley Medical Center, 550 N Hillside Street, Wichita, KS 67214, United States of America.

出版信息

Am J Emerg Med. 2021 Jun;44:33-37. doi: 10.1016/j.ajem.2021.01.091. Epub 2021 Feb 3.

Abstract

INTRODUCTION

Longer prehospital times were associated with increased odds for survival in trauma patients. The purpose of this study was to determine how the COVID-19 pandemic affected emergency medical services (EMS) prehospital times for trauma patients.

METHODS

This retrospective cohort study compared trauma patients transported via EMS to six US level I trauma centers admitted 1/1/19-12/31/19 (2019) and 3/16/20-6/30/20 (COVID-19). Outcomes included: total EMS pre-hospital time (dispatch to hospital arrival), injury to dispatch time, response time (dispatch to scene arrival), on-scene time (scene arrival to scene departure), and transportation time (scene departure to hospital arrival). Fisher's exact, chi-squared, or Kruskal-Wallis tests were used, alpha = 0.05. All times are presented as median (IQR) minutes.

RESULTS

There were 9400 trauma patients transported by EMS: 79% in 2019 and 21% during the COVID-19 pandemic. Patients were similar in demographics and transportation mode. Emergency room deaths were also similar between 2019 and COVID-19 [0.6% vs. 0.9%, p = 0.13].There were no differences between 2019 and during COVID-19 for total EMS prehospital time [44 (33, 63) vs. 43 (33, 62), p = 0.12], time from injury to dispatch [16 (6, 55) vs. 16 (7, 77), p = 0.41], response time [7 (5, 12) for both groups, p = 0.27], or on-scene time [16 (12-22) vs. 17 (12,22), p = 0.31]. Compared to 2019, transportation time was significantly shorter during COVID-19 [18 (13, 28) vs. 17 (12, 26), p = 0.01].

CONCLUSION

The median transportation time for trauma patients was marginally significantly shorter during COVID-19; otherwise, EMS prehospital times were not significantly affected by the COVID-19 pandemic.

摘要

简介

较长的院前时间与创伤患者的存活几率增加有关。本研究的目的是确定 COVID-19 大流行如何影响创伤患者的紧急医疗服务 (EMS) 院前时间。

方法

本回顾性队列研究比较了通过 EMS 送往美国 6 家一级创伤中心的创伤患者,纳入时间为 1/1/19-12/31/19(2019 年)和 3/16/20-6/30/20(COVID-19 年)。结果包括:EMS 院前总时间(调度至医院到达)、伤害至调度时间、反应时间(调度至现场到达)、现场时间(现场到达至现场离开)和运输时间(现场离开至医院到达)。Fisher 精确检验、卡方检验或 Kruskal-Wallis 检验,α=0.05。所有时间均以中位数(IQR)分钟表示。

结果

共有 9400 名创伤患者通过 EMS 转运:2019 年占 79%,COVID-19 年占 21%。患者在人口统计学和运输方式方面相似。急诊室死亡率在 2019 年和 COVID-19 年之间也相似[0.6% vs. 0.9%,p=0.13]。在 2019 年和 COVID-19 期间,EMS 院前总时间[44(33,63)与 43(33,62),p=0.12]、伤害至调度时间[16(6,55)与 16(7,77),p=0.41]、反应时间[两组均为 7(5,12),p=0.27]或现场时间[16(12-22)与 17(12,22),p=0.31]无差异。与 2019 年相比,COVID-19 期间转运时间明显缩短[18(13,28)与 17(12,26),p=0.01]。

结论

COVID-19 期间创伤患者的中位转运时间略有显著缩短;否则,EMS 院前时间受 COVID-19 大流行影响不显著。

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