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突发事件中紧急医疗服务的院前反应时间和分诊的效果:一项回顾性研究。

Prehospital Response Time of the Emergency Medical Service during Mass Casualty Incidents and the Effect of Triage: A Retrospective Study.

机构信息

Department of Neurological Surgery, Mayo Clinic, Jacksonville, USA.

Department of Orthopedic Surgery, OLVG Amsterdam, the Netherlands.

出版信息

Disaster Med Public Health Prep. 2022 Jun;16(3):1091-1098. doi: 10.1017/dmp.2021.40. Epub 2021 Apr 12.

Abstract

OBJECTIVE

Prehospital time affects survival in trauma patients. Mass casualty incidents (MCIs) are overwhelming events where medical care exceeds available resources. This study aimed at evaluating the prehospital time during MCIs and investigating the effect of triage.

METHODS

A retrospective analysis was performed using Florida's Event Medical Services Tracking and Reporting System database. All patients involved in MCIs during 2018 were accessed, and prehospital time intervals were evaluated and compared to that of non-MCIs. The effect of MCI triage and field triage (Field Triage Criteria) on prehospital time was evaluated.

RESULTS

In 2018, it was estimated that 2236 unique MCIs occurred in Florida, with a crude incidence of 10.1-10.9/100000 people. 2180 EMS units arrived at the hospital for patient disposition with a median alarm-to-hospital time of 43.74 minutes, significantly longer than non-MCIs (39.15 min; < 0.001). MCI triage and field triage were both associated with shorter alarm-to-hospital time (39.37 min and 37.55 min, respectively).

CONCLUSIONS

MCIs resulted in longer prehospital time intervals than non-MCIs. This finding suggests that additional efforts are needed to reduce the prehospital time for MCI patients. MCI triage and field triage were both associated with shorter alarm-to-hospital times. Widespread use may improve prehospital MCI care.

摘要

目的

创伤患者的院前时间影响其存活率。大批伤员事件(MCIs)是医疗资源超过可利用资源的压倒性事件。本研究旨在评估 MCI 期间的院前时间,并调查分诊的效果。

方法

使用佛罗里达州事件医疗服务跟踪和报告系统数据库进行回顾性分析。获取 2018 年所有涉及 MCI 的患者,并评估和比较其院前时间间隔与非 MCI 的时间间隔。评估 MCI 分诊和现场分诊(现场分诊标准)对院前时间的影响。

结果

2018 年,估计佛罗里达州发生了 2236 起独特的 MCI,粗发病率为 10.1-10.9/100000 人。2180 个 EMS 单位到达医院进行患者处置,中位报警至医院时间为 43.74 分钟,明显长于非 MCI(39.15 分钟;<0.001)。MCI 分诊和现场分诊均与较短的报警至医院时间相关(分别为 39.37 分钟和 37.55 分钟)。

结论

MCI 导致的院前时间间隔长于非 MCI。这一发现表明,需要额外努力来减少 MCI 患者的院前时间。MCI 分诊和现场分诊均与较短的报警至医院时间相关。广泛使用可能会改善 MCI 的院前护理。

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