Beddingfield F C, Garrison H G, Manning J E, Lewis R J
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance 90509-2910.
Pediatr Emerg Care. 1996 Dec;12(6):416-9. doi: 10.1097/00006565-199612000-00007.
The purpose of this study was to determine factors associated with longer times to transport of emergency pediatric patients requiring tertiary care.
Retrospective case series.
Emergency pediatric transport service.
Infants and children transported by the transport service at the University of North Carolina Hospitals at Chapel Hill from January 1, 1988, to December 31, 1990.
The time-to-request, the time from patient arrival at the referring hospital to the time when the request for transfer was received, and the ground time, defined as the time between the transport team's arrival at the referring hospital and their departure, were recorded for each transported patient.
Three hundred consecutive children 0 to 16 years (61% male) were transferred. Time-to-request was shorter for trauma patients (median 62 minutes, quartiles 29 and 153 minutes) than for medical patients (median 172 minutes, quartiles 83 and 508 minutes) (P = 0.0001). Infants, children, and adolescents had similar times-to-request of 147 minutes, 129 minutes, and 128 minutes, respectively (P = 0.91). Increased ground times were associated with diagnosis category (median of 40 minutes for medical patients vs 29 minutes for trauma patients) (P = 0.0001), with younger age (median of 46 minutes for infants, 35 minutes for children, and 28 minutes for adolescents) (P = 0.0001), and with the performance of major procedures (median of 35 minutes if no procedures were performed, 38 minutes if one procedure was performed, and 54 minutes if two procedures were performed) (P = 0.039). After the transport team arrived, 13% (40/300) of patients required at least one major procedure prior to transport.
Increased time-to-request for patients with medical diagnoses, increased ground times for younger patients and patients with medical diagnoses, and failure to perform necessary procedures contribute to a prolongation of the time-to-transport of emergency pediatric patients. The magnitude of the impact of these longer transport times on outcome is unknown.
本研究的目的是确定与需要三级护理的急诊儿科患者转运时间延长相关的因素。
回顾性病例系列研究。
急诊儿科转运服务机构。
1988年1月1日至1990年12月31日期间由北卡罗来纳大学教堂山分校医院的转运服务机构转运的婴儿和儿童。
记录每位转运患者的请求时间（即患者到达转诊医院至收到转运请求的时间）以及地面时间（即转运团队到达转诊医院至离开的时间）。
连续300名0至16岁儿童（61%为男性）被转运。创伤患者的请求时间（中位数62分钟，四分位数间距29至153分钟）短于内科患者（中位数172分钟，四分位数间距83至508分钟）（P = 0.0001）。婴儿、儿童和青少年的请求时间分别相似，为147分钟、129分钟和128分钟（P = 0.91）。地面时间延长与诊断类别有关（内科患者中位数为40分钟，创伤患者为29分钟）（P = 0.0001），与年龄较小有关（婴儿中位数为46分钟，儿童为35分钟，青少年为28分钟）（P = 0.0001），还与进行主要操作有关（未进行操作时中位数为35分钟，进行一项操作时为38分钟，进行两项操作时为54分钟）（P = 0.039）。转运团队到达后，13%（40/300）的患者在转运前需要至少进行一项主要操作。
内科诊断患者的请求时间增加、年龄较小患者和内科诊断患者的地面时间增加以及未进行必要操作导致急诊儿科患者的转运时间延长。这些较长转运时间对结局的影响程度尚不清楚。
