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对护理人员在低血糖发作后转诊至社区糖尿病服务机构的糖尿病患者的再次联系率和临床特征进行回顾性横断面分析。

A retrospective cross-sectional analysis of re-contact rates and clinical characteristics in diabetic patients referred by paramedics to a community diabetes service following a hypoglycaemic episode.

作者信息

Bloomer Karl

机构信息

Northern Ireland Ambulance Service ORCID iD: https://orcid.org/0000-0002-7822-4528.

出版信息

Br Paramed J. 2021 Sep 1;6(2):1-9. doi: 10.29045/14784726.2021.9.6.2.1.

Abstract

AIMS

To report the re-contact rates and clinical characteristics of individuals referred to community diabetic teams following non-conveyance by HCPC paramedics.

METHODS

A retrospective cross-sectional study of routinely collected data by the Northern Ireland Ambulance Service HSC Trust of individuals referred to a community diabetic service following ambulance attendance and non-conveyance. Data were collected over a 3-month period with ambulance service re-contact and clinical data analysed.

RESULTS

418 emergency calls were identified as relating to hypoglycaemia with 169 referrals being made, a referral rate of 40.4%. Patients treated with insulin represented the majority of calls and tended to have a lower Glasgow Coma Scale score, but demonstrated many successful referrals. Increased age and multimorbidity were associated with repeat hypoglycaemic episodes and EMS attendance while other subgroups traditionally considered higher risk, such as patients with infections or under the influence of alcohol, showed potential for safe community management.

CONCLUSION

The majority of paramedic referrals to community diabetic teams were successful, with less than 5% re-contacting the ambulance service within 3 days. This study, although demonstrating a lower referral rate than previous research, reinforces the safety of paramedic management and community referral for hypoglycaemia.

摘要

目的

报告在医护人员未将患者转运的情况下被转介至社区糖尿病团队的个体的再次联系率及临床特征。

方法

对北爱尔兰救护车服务HSC信托机构常规收集的关于在救护车出诊但未转运后被转介至社区糖尿病服务的个体数据进行回顾性横断面研究。在3个月期间收集数据,并对救护车服务再次联系情况及临床数据进行分析。

结果

418次紧急呼叫被确定与低血糖有关,共进行了169次转介,转介率为40.4%。接受胰岛素治疗的患者占呼叫的大多数,且格拉斯哥昏迷量表评分往往较低,但成功转介的情况较多。年龄增加和多种疾病与反复低血糖发作及紧急医疗服务出勤有关,而其他传统上被认为风险较高的亚组,如感染患者或受酒精影响的患者,显示出可在社区安全管理的可能性。

结论

医护人员转介至社区糖尿病团队的大多数情况是成功的,不到5%的患者在3天内再次联系救护车服务。本研究虽然显示转介率低于先前研究,但强化了医护人员对低血糖管理及社区转介的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/115e/8415207/638bf26b5937/BPJ-2021-6-2-1-g001.jpg

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