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[新型冠状病毒肺炎疫情封锁对紧急医疗服务运作的影响]

[Impact of the COVID-19 lockdown on emergency medical service operations].

作者信息

Müller Frank, Hummers Eva, Jablonka Alexandra, Schmidt Tobias, Noack Eva Maria

机构信息

Institut für Allgemeinmedizin, Universitätsmedizin Göttingen, Humboldtallee 38, 37073 Göttingen, Deutschland.

Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Hannover, Deutschland.

出版信息

Notf Rett Med. 2022;25(5):341-347. doi: 10.1007/s10049-021-00873-1. Epub 2021 Apr 22.

Abstract

BACKGROUND

As a response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, extensive contact restrictions were imposed by law in Germany as in other European countries. The present study intends to clarify the effect of these restrictions on emergency medical service (EMS) operations.

MATERIALS AND METHODS

Retrospective chart review of EMS operation protocols over the first 6 months of 2020 ( = 6668 rescue missions) in four rescue stations in eastern Lower Saxony (Germany). Description and statistical comparison of operations 6 weeks before the restrictions with an equally long period after the order of the restrictions ("lockdown").

RESULTS

During the 6 weeks after the lockdown the frequency of rescue operations decreased by 17.7%. In particular, there was a 40.6% ( = 91) decrease of emergency cases with respiratory diseases, mainly due to a decline of pneumonia and exacerbated chronic-obstructive pulmonary disease (COPD). At the same time, patients' mean age increased with fewer patients under 65 years. There were no changes in the frequency of psychiatric disorders, deceased or injured patients, or refusal of treatment and transport. A total of 67 patients with suspected or confirmed SARS-CoV‑2 infection (1.0%) were observed during this period.

DISCUSSION

EMS experienced a reduction of operations as a result of contact restrictions, although not as pronounced as was recently described for emergency rooms. This supports the hypothesis that the reduction is particularly evident in less severe cases and in younger patients. The reduction in pneumonia and COPD cases is striking. On the one hand, this could indicate that contact restrictions reduce the incidence of other respiratory infections and their impact on chronic respiratory disorders, but it could also mean that patients try to avoid hospital treatment.

摘要

背景

作为对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)大流行的应对措施,德国与其他欧洲国家一样依法实施了广泛的接触限制。本研究旨在阐明这些限制对紧急医疗服务(EMS)运作的影响。

材料与方法

对德国下萨克森州东部四个救援站2020年上半年的EMS运作协议进行回顾性图表审查(共6668次救援任务)。对限制措施实施前6周的运作情况与限制令发布后同样长的时间段(“封锁期”)进行描述和统计比较。

结果

封锁期后的6周内,救援行动频率下降了17.7%。特别是,呼吸道疾病紧急病例减少了40.6%(91例),主要原因是肺炎和慢性阻塞性肺疾病(COPD)急性加重病例减少。与此同时,患者的平均年龄有所增加,65岁以下患者减少。精神障碍、死亡或受伤患者的频率以及拒绝治疗和转运的情况均无变化。在此期间共观察到67例疑似或确诊SARS-CoV-2感染患者(1.0%)。

讨论

EMS因接触限制而导致运作减少,尽管不像最近急诊室报道的那么明显。这支持了以下假设,即这种减少在病情较轻的病例和年轻患者中尤为明显。肺炎和COPD病例的减少引人注目。一方面,这可能表明接触限制降低了其他呼吸道感染的发病率及其对慢性呼吸道疾病的影响,但也可能意味着患者试图避免住院治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc0b/8060906/c899a51657a0/10049_2021_873_Fig1_HTML.jpg

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