视频通信能否提高紧急医疗通信中心的调度精度？挪威直升机紧急医疗服务的前后研究。
Can video communication in the emergency medical communication centre improve dispatch precision? A before-after study in Norwegian helicopter emergency medical services.
机构信息
Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway
Department of Emergency Medicine and Pre-hospital Services, St Olav's University Hospital, Trondheim, Norway.
出版信息
BMJ Open. 2023 Oct 29;13(10):e077395. doi: 10.1136/bmjopen-2023-077395.
OBJECTIVES
Dispatching helicopter emergency medical services (HEMS) to the patients with the greatest medical or logistical benefit remains challenging. The introduction of video calls (VC) in the emergency medical communication centres (EMCC) could provide additional information for EMCC operators and HEMS physicians when assessing the need for HEMS dispatch. The aim of this study was to evaluate the impact from VC in the EMCC on HEMS dispatch precision.
DESIGN
An observational before-after study.
SETTING
The regional EMCC and one HEMS base in Mid-Norway.
PARTICIPANTS
EMCC operators and HEMS physicians at the EMCC and HEMS base in Trondheim, Norway.
INTERVENTION
In January 2022, VC became available in emergency calls in Trondheim EMCC. Data were collected from 2020 2021 (pre-intervention) and 2022 (post-intervention).
PRIMARY AND SECONDARY OUTCOME MEASURES
The primary outcome was the proportion of seriously ill or injured HEMS patients, defined as a National Advisory Committee for Aeronautics (NACA) score between 4 and 7. The secondary outcome was the proportion of inappropriate dispatches, defined as missions with neither provision of additional competence nor any logistical contribution based on quality indicators for physician-staffed emergency medical services.
RESULTS
811 and 402 HEMS missions with patient contact were included in the pre- and post-intervention group, respectively. The proportion of missions with NACA 4-7 was not significantly changed after the intervention (OR 1.21, 95% CI 0.92 to 1.61, p=0.17). There was no significant change in HEMS alarm times between the pre- and post-intervention groups (7.6 min vs 6.4 min, p=0.15). The proportion of missions with neither medical nor logistical benefit was significantly lower in the post-intervention group (28.4% vs 40.3%, p=0.007).
CONCLUSION
The results from this study indicate that VC is a promising, feasible and safe tool for EMCC operators in the complex HEMS dispatch process.
目的
为患者派遣最能带来医学或后勤效益的直升机紧急医疗服务（HEMS）仍然具有挑战性。在紧急医疗通讯中心（EMCC）引入视频通话（VC），可以为 EMCC 操作员和 HEMS 医生在评估 HEMS 派遣需求时提供额外信息。本研究旨在评估 EMCC 中的 VC 对 HEMS 派遣精度的影响。
设计
一项观察性前后研究。
地点
挪威中北部的区域 EMCC 和一个 HEMS 基地。
参与者
挪威特隆赫姆的 EMCC 和 HEMS 基地的 EMCC 操作员和 HEMS 医生。
干预措施
2022 年 1 月，特隆赫姆 EMCC 推出了紧急呼叫中的 VC。数据收集于 2020 年至 2021 年（干预前）和 2022 年（干预后）。
主要和次要结果
主要结果是病情严重或受伤的 HEMS 患者的比例，定义为国家航空咨询委员会（NACA）评分 4 至 7 分。次要结果是不适当派遣的比例，定义为既没有提供额外能力，也没有根据配备医生的紧急医疗服务的质量指标提供任何后勤贡献的任务。
结果
干预前和干预后分别纳入了 811 次和 402 次有患者接触的 HEMS 任务。干预后 NACA 4-7 分的任务比例没有显著变化（OR 1.21，95%CI 0.92 至 1.61，p=0.17）。干预前和干预后 HEMS 报警时间没有显著变化（7.6 分钟与 6.4 分钟，p=0.15）。干预后无医疗或后勤效益的任务比例显著降低（28.4%与 40.3%，p=0.007）。
结论
本研究结果表明，VC 是 EMCC 操作员在复杂 HEMS 派遣过程中的一种有前途、可行且安全的工具。
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