Tokunaga Shungo, Ikeda A I, Usuda Daisuke, Kawai Kenji, Sakurai Riki, Tsuge Shiho, Matsubara Shun, Suzuki Makoto, Tanaka Risa, Shimozawa Shintaro, Hotchi Yuta, Osugi Ippei, Kondo Akihiko, Mishima Kentaro, Mizuno Keiko, Komatsu Takayuki, Takami Hiroki, Oba Jiro, Nomura Tomohisa, Sugita Manabu
Juntendo Iji Zasshi. 2024 Sep 30;70(5):376-383. doi: 10.14789/jmj.JMJ24-0035-OA. eCollection 2024.
To evaluate the effect of emergency medicine training credentials and years of medical experience on various clinical parameters in emergency medicine practice.
A cross-sectional study was conducted at Juntendo University Nerima Hospital between 1 April 2019 and 31 March 2020. All patients who were transported by ambulance, were examined by emergency physicians, and underwent computed tomography (CT) or magnetic resonance imaging (MRI) in the emergency department were included. For these cases, data on the attending physician's qualification status and experience (specialist, nonspecialist with 1-2 years of experience, or nonspecialist with 3-4 years of experience), clinical parameters, and imaging were collected. The primary outcome was the patient's total length of stay (LOS) in the emergency department.
A total of 3,784 patients were included in the study. Patients attended by nonspecialists with 1-2 years of experience had a significantly longer time from arrival to assessment and LOS, especially in mild and severe cases and cases requiring head and abdominal CT imaging.
Our findings suggest that for physicians with minimal work experience, mentorship and effective training using triage flow and medical examination protocols may help to reduce LOS in the emergency department.
评估急救医学培训资质和医疗经验年限对急救医学实践中各项临床参数的影响。
于2019年4月1日至2020年3月31日在顺天堂大学练马医院开展一项横断面研究。纳入所有由救护车转运、经急诊医师检查并在急诊科接受计算机断层扫描(CT)或磁共振成像(MRI)检查的患者。针对这些病例,收集主治医生的资质状况和经验(专科医生、有1 - 2年经验的非专科医生或有3 - 4年经验的非专科医生)、临床参数及影像学检查等数据。主要结局指标为患者在急诊科的总住院时间(LOS)。
本研究共纳入3784例患者。由有1 - 2年经验的非专科医生诊治的患者,从就诊到评估的时间以及住院时间显著更长,尤其是在轻症和重症病例以及需要进行头部和腹部CT成像的病例中。
我们的研究结果表明,对于工作经验较少的医生,采用分诊流程和体格检查方案进行指导和有效培训,可能有助于缩短患者在急诊科的住院时间。