救护车医护人员与现场的实时视频通信——基于模拟的研究。
Real-time video communication between ambulance paramedic and scene - a simulation-based study.
机构信息
Community Division, Magen David Adom, Ha-Plada 5, 6021805, Or-Yehuda, Israel.
Department of Emergency Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
出版信息
BMC Health Serv Res. 2022 Aug 17;22(1):1049. doi: 10.1186/s12913-022-08445-w.
INTRODUCTION
Telemedicine has been widely used in various medical settings including in Emergency Medical Services (EMS). The goal of this study was to assess the possible roles of real-time video communication between paramedics and bystanders at scenes of emergency, in the analysis and treatment of patients.
METHODS
44 experienced paramedics participated in a simulation. Participants communicated with the experimenter presenting video clips showing patients that simulated three emergency scenarios: trauma, an unresponsive patient with cardiac arrest, and an opiate overdose. The simulation sessions were conducted through Zoom™, recorded, and then analyzed to document participants' questions, requests, instructions, and their timings during each scenario.
RESULTS
The trauma scenario was assessed most promptly, with instructions to handle the bleeding provided by all paramedics. In the unresponsive patient with cardiac arrest scenario, most of the participants achieved a correct initial diagnosis, and in the opiate overdose scenario over half of paramedics sought visual clinical clues for the differential diagnoses of loss of consciousness and their causes. Additional results show the type of assessment, treatment and diagnosis participants provided in each scenario, and their confidence about situation.
CONCLUSIONS
The findings show that direct video communication between paramedic and scene may facilitate correct diagnosis, provision of instructions for treatment, and early preparation of medications or equipment. These may decrease time to correct diagnosis and lifesaving treatment and impact patient morbidity and mortality. Moreover, the findings highlight the difference between incidents with higher visual clarity, such as trauma, and conditions that require an extended diagnosis to reveal, such as unresponsive patients. This may also increase the paramedics' mental preparedness for what is expected at the scene.
简介
远程医疗已广泛应用于各种医疗环境，包括在紧急医疗服务（EMS）中。本研究的目的是评估急救现场护理人员与旁观者之间实时视频通信在患者分析和治疗中的可能作用。
方法
44 名经验丰富的护理人员参与了模拟实验。参与者与实验者进行沟通，通过视频片段展示模拟的三种紧急情况的患者：创伤、无反应性心搏骤停患者和阿片类药物过量。模拟通过 ZoomTM 进行，进行了录制，然后对参与者在每个场景中的问题、请求、指示和时间进行分析。
结果
创伤场景评估最快，所有护理人员都提供了处理出血的指示。在无反应性心搏骤停患者的场景中，大多数参与者做出了正确的初步诊断，而在阿片类药物过量的场景中，超过一半的护理人员寻求视觉临床线索来区分意识丧失及其原因。其他结果显示了参与者在每个场景中提供的评估、治疗和诊断类型，以及他们对情况的信心。
结论
研究结果表明，护理人员与现场之间的直接视频通信可以促进正确诊断、提供治疗指示，并为药物或设备的早期准备提供便利。这可能会缩短正确诊断和救生治疗的时间，并影响患者的发病率和死亡率。此外，研究结果强调了高清晰度视觉的事件（如创伤）和需要延长诊断才能揭示的情况（如无反应性患者）之间的差异。这也可能会增加护理人员对现场预期情况的心理准备。
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