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[耳鼻喉科急症的初步评估——一项可行性研究]

[Initial assessment of ENT emergencies-a feasibility study].

作者信息

Krafft Eva, Kaulitz Stefan, Voelker Johannes, Engert Jonas, Spahn Björn, Hagen Rudolf, Rak Kristen

机构信息

Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Deutschland.

出版信息

HNO. 2025 Feb;73(2):111-121. doi: 10.1007/s00106-024-01434-x. Epub 2024 Feb 22.

Abstract

In Germany, an increased volume of patient cases in the emergency department has been observed for several years, many of which do not represent hospital emergencies. To improve the triage and management of patient flows, the Structured Initial Medical Assessment (Strukturierte medizinische Ersteinschätzung in Deutschland, SmED) triage system was developed. This certified medical product is intended to assess both the urgency of everyday complaints and their adequate medical care in a targeted, faster, and safer manner. It supports medical professionals in triage by suggesting courses of action, whereby the ultimate responsibility remains with the professionals themselves. For otorhinolaryngology, a content review was carried out with regard to plausibility and patient safety in the head and neck region on the basis of nine specific emergencies. The cases were simulated by nine otorhinolaryngologists and triaged on the basis of the SmED by medical staff and medical students by assigning a care level and timepoint (urgency). The majority of cases were correctly assigned. The SmED initial assessment system is a good tool for assessing urgent clinical pictures in ear, nose, and throat (ENT) medicine. The long-term goal of the initial assessment is to relieve the capacities of outpatient departments. In order to achieve this and to shorten patient waiting times, it would be necessary to refer patients quickly to otorhinolaryngology. It is therefore necessary to ensure that patients are referred to an ENT on-call service via the online tool.

摘要

在德国,急诊部门的患者病例数量增加已持续数年,其中许多并非医院急症。为改善患者流量的分诊和管理,开发了结构化初始医学评估(德国结构化医学初始评估,SmED)分诊系统。这种经过认证的医疗产品旨在以有针对性、更快且更安全的方式评估日常病症的紧迫性及其适当的医疗护理。它通过建议行动方案来支持医疗专业人员进行分诊,不过最终责任仍由专业人员自行承担。对于耳鼻喉科,基于九种特定急症对头颈部区域的合理性和患者安全进行了内容审查。这些病例由九名耳鼻喉科医生进行模拟,医护人员和医学生根据SmED通过分配护理级别和时间点(紧迫性)进行分诊。大多数病例被正确分诊。SmED初始评估系统是评估耳鼻喉科急症临床症状的良好工具。初始评估的长期目标是减轻门诊部门的负担。为实现这一目标并缩短患者等待时间,有必要将患者迅速转诊至耳鼻喉科。因此,必须确保通过在线工具将患者转诊至耳鼻喉科随叫随到服务。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2942/11772389/ae05c694d99b/106_2024_1434_Fig1_HTML.jpg

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