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创伤性道路碰撞事故管理中紧急远程医疗支持使用模式。

Patterns in the Use of Emergency Telemedicine Support in the Management of Traumatic Road Crashes.

机构信息

Clinical Excellence Queensland, Queensland Health, Brisbane, Australia.

Retrieval Services Queensland, Queensland Health, Brisbane, Australia.

出版信息

Telemed J E Health. 2024 Feb;30(2):579-584. doi: 10.1089/tmj.2023.0125. Epub 2023 Aug 25.

Abstract

The introduction of emergency telemedicine care models is a common theme in health jurisdictions that include rural and remote populations. How the availability of these models influences the way clinicians manage traumatic road crashes is not yet fully understood. This study seeks to compare road crashes where telemedicine was and was not used and to identify any variables that may increase the likelihood of telemedicine usage by treating clinicians. Road crashes reported in the state Department of Transport and Main Roads (Queensland, Australia) crash database between January 1, 2019, and November 30, 2020 ( = 23,734) were compared to videoconferencing call logs to determine which crashes resulted in treatment that was supported by telemedicine ( = 204). Analysis was performed to examine differences in characteristics related to the crash depending on whether telemedicine support was requested. Road crashes where telemedicine support was requested on average involved more casualties (1.6 vs. 1.41; (11,287) = -3.26, < 0.001, relative risk = 1.13). Crashes that occurred in rural settings accounted for most requests for telemedicine (65.68%;  = 159.2, < 0.001) and a greater percentage of crashes in remote locations (3.36% vs. 2.35%;  = 256.97, < 0.001, relative risk = 1.43). The use of telemedicine support for crashes was associated with a 13% increase in the mean number of casualties, compared to crashes where telemedicine support was not used. Telemedicine support is requested by clinicians providing emergency treatment in the management of road crashes that produce more severe injuries, involve multiple casualties, and take place in more rural settings or remote locations.

摘要

引入紧急远程医疗护理模式是包括农村和偏远地区在内的卫生司法管辖区的一个共同主题。这些模式的可用性如何影响临床医生处理创伤性道路碰撞的方式尚不完全清楚。本研究旨在比较使用和未使用远程医疗的道路碰撞,并确定可能增加治疗临床医生使用远程医疗可能性的任何变量。

2019 年 1 月 1 日至 2020 年 11 月 30 日,昆士兰州交通和主要道路部(澳大利亚)碰撞数据库中报告的道路碰撞( = 23,734)与视频会议通话记录进行了比较,以确定哪些碰撞导致了远程医疗支持的治疗( = 204)。分析旨在检查与碰撞相关的特征差异,具体取决于是否请求远程医疗支持。

平均而言,请求远程医疗支持的道路碰撞涉及更多伤亡(1.6 与 1.41;(11,287) = -3.26, < 0.001,相对风险 = 1.13)。农村地区发生的碰撞占远程医疗请求的大部分(65.68%; = 159.2, < 0.001),偏远地区发生的碰撞比例也更高(3.36%与 2.35%; = 256.97, < 0.001,相对风险 = 1.43)。与未使用远程医疗支持的碰撞相比,使用远程医疗支持的碰撞中,伤亡人数平均增加了 13%。

在处理导致更严重伤害、涉及多名伤亡人员以及发生在农村或偏远地区的道路碰撞时,提供紧急治疗的临床医生会请求远程医疗支持。

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