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[从急诊医生视角看精神科急症]

[Psychiatric emergencies from the viewpoint of the emergency physician].

作者信息

Pajonk F G, Biberthaler P, Cordes O, Moecke H P

机构信息

Klinik für Psychiatrie und Psychotherapie, Universitätskrankenhaus Eppendorf, Hamburg.

出版信息

Anaesthesist. 1998 Jul;47(7):588-94. doi: 10.1007/s001010050600.

DOI:10.1007/s001010050600
PMID:9740933
Abstract

OBJECTIVE

In the German physician-based emergency medical system (EMS) psychiatric emergency situations (PES) rank on third place contradictory to it's importance during emergency physician training program. The aim of our study was to examine the relevance of PES and the stress which PES imposes upon EMS physicians. Further, the interest of training programs on that issue was determined. Knowledge about PES was investigated by a short test.

METHODS

952 emergency physicians were sent a questionnaire about following: demographic data, frequency of PES, strain by PES, own knowledge, interest about training programs. Further five typical PES were presented for diagnostic and therapeutic judgement.

RESULTS

222 responded (183 men/37 women/2 without gender data, average age: 40.1 +/- 6.7, qualification as emergency physician: 9.6 +/- 5.1 years, most frequent subspeciality in-hospital physicians: anaesthesiology 67.5%, in-practice physicians: general medicine 72.1%). PES frequence was estimated at 9.4%, personal knowledge judged only by 13% as sufficient, 14.2 felt incapable by PES. 73% saw importance of training, especially expressed by the more experienced (P < 0.05). Test presented 65% correct diagnoses, 33% correct therapy, 26% incorrect decision of hospital admission.

CONCLUSION

PES are a frequent problem of pre-hospital patient care for emergency physicians. As personal knowledge was estimated to be insufficient, the interest for courses concerning PES issues is high.

摘要

目的

在德国基于医生的紧急医疗系统(EMS)中,精神科紧急情况(PES)的重要性与其在急诊医生培训项目中的排名(第三位)相矛盾。我们研究的目的是检验PES的相关性以及PES给EMS医生带来的压力。此外,还确定了培训项目对该问题的关注度。通过一个简短测试调查了关于PES的知识。

方法

向952名急诊医生发送了一份问卷,内容包括:人口统计学数据、PES的发生频率、PES造成的压力、自身知识、对培训项目的兴趣。还给出了五个典型的PES病例用于诊断和治疗判断。

结果

222人回复(183名男性/37名女性/2人无性别数据,平均年龄:40.1±6.7岁,急诊医生资质:9.6±5.1年,医院医生中最常见的亚专业:麻醉学67.5%,执业医生中:普通医学72.1%)。PES的发生率估计为9.4%,只有13%的人认为自己的个人知识足够,14.2%的人觉得应对PES力不从心。73%的人认为培训很重要,经验更丰富的医生尤其有此表示(P<0.05)。测试中正确诊断率为65%,正确治疗率为33%,住院决策错误率为26%。

结论

PES是急诊医生院前患者护理中经常遇到的问题。由于个人知识被认为不足,对有关PES问题课程的兴趣很高。

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Emergency medical care of patients with psychiatric disorders -  challenges and opportunities: Results of a multicenter survey.精神障碍患者的急诊医疗护理 - 挑战与机遇:一项多中心调查的结果。
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[The situation of emergency psychiatry in Germany].
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