Soni Ashwani, Garg Sudhir Kumar, Gupta Ravi, Gupta Parmanand, Kansay Rajeev, Singhal Akash
Government Medical College Hospital, Chandigarh, India.
Government Medical College and Hospital, Chandigarh, India.
J Clin Orthop Trauma. 2021 Dec;23:101654. doi: 10.1016/j.jcot.2021.101654. Epub 2021 Oct 21.
Pre-hospital care has been shown to reduce the mortality in trauma patients. The present study is an attempt to identify the status of pre-hospital orthopaedic trauma care in developing countries during COVID-19 pandemic.
This was a prospective observational study carried out in a tertiary care setup from March 25th 2020 to January 31st 2021. All the data pertaining to the traumatic injuries including demographic details and epidemiologic characteristics were recorded in an electronic database.
A total of 1044 patients were included in the study for evaluation. The mean age was 35.24 ± 19.84 years. There were 873 males and 171 females. A total of 748 presented from nearby states, with 401 being the referrals and 347 cases coming directly to hospital. A total of 141 open fractures presented directly and 269 were referred from nearby states. Out of 269 cases of open fractures, only 67 and 139 were given intravenous antibiotics and had wound dressing done respectively at the periphery site. A total of 125, 112, 92 and 84 patients were received without traction/splintage, intravenous fluids, dose of analgesics and recording of vitals respectively. Delay from injury to presentation in emergency/administration of antibiotic (Hours) was 7.06. Road side accidents were main cause comprising of 52.58% cases. Gustilo Anderson classification grade-2 comprised of majority of the open fractures (51.63%). Lower limb fractures comprised of majority of the injuries (70.59%). Majority were adults and conservative management was the most common mode of treatment. A total of 197 and 265 patients had associated head injuries and blunt trauma chest/blunt trauma abdomen respectively.
Emphasizing on pre-hospital care measures, with special focus on co-ordination between primary, secondary and tertiary health care facilities is the need of the hour and can prevent additional morbidities, avoiding overburden of the already compromised healthcare centres.
院前护理已被证明可降低创伤患者的死亡率。本研究旨在确定新冠疫情期间发展中国家院前骨科创伤护理的现状。
这是一项前瞻性观察研究，于2020年3月25日至2021年1月31日在一家三级医疗机构开展。所有与创伤性损伤相关的数据，包括人口统计学细节和流行病学特征，均记录在一个电子数据库中。
共有1044例患者纳入本研究进行评估。平均年龄为35.24±19.84岁。男性873例，女性171例。共有748例来自附近各州，其中401例为转诊患者，347例直接到院就诊。共有141例开放性骨折直接到院，269例从附近各州转诊而来。在269例开放性骨折病例中，仅67例和139例分别在周边地点接受了静脉抗生素治疗和伤口包扎。分别有125例、112例、92例和84例患者在未接受牵引/夹板固定、静脉输液、镇痛剂剂量治疗和生命体征记录的情况下入院。从受伤到在急诊室就诊/使用抗生素的延迟时间（小时）为7.06。路边事故是主要原因，占病例的52.58%。多数开放性骨折为 Gustilo Anderson 分类2级（51.63%）。下肢骨折占损伤的大多数（70.59%）。多数为成年人，保守治疗是最常见的治疗方式。共有197例和265例患者分别伴有头部损伤和钝性胸部创伤/钝性腹部创伤。
当下需要强调院前护理措施，特别关注初级、二级和三级医疗保健机构之间的协调，这可以预防额外的发病率，避免使本已不堪重负的医疗中心负担过重。
