【摘要】 目的 探討腹部閉合性損傷的外科急救方法。方法 2003年1月—2009年1月收治200例腹部閉合性損傷患者,根據病史、體征、輔助檢查等做出診斷后,在確保重要器官血流供應的基礎上進行外科手術治療。結果 治愈187例,治愈率93.5％；死亡13例,9例患者死于多臟器受損引起的出血性休克,2例脾破裂患者因失血過多術中死亡,2例患者因合并顱腦損傷形成腦疝死亡。結論 對于腹部閉合性損傷患者,應快速準確地根據病史、體征、輔助檢查等做出診斷,進行積極外科急救治療。有效控制出血,保證重要器官血液供應,是外科急救能否成功的關鍵。
目的 調查在院前急救中醫患雙方對留置針使用的滿意度，并就留置針在急救中應用的合理性進行研究。 方法 將我院急診科2011年6月－8月院前急救的患者，按出診順序分為兩組，觀察組患者使用留置針穿刺建立靜脈通道，對照組則采用一次性靜脈輸液針，并調查患者或親屬、穿刺操作護士就兩種穿刺方法的滿意度。 結果 觀察組留置針一次穿刺成功者達198例（94.29%），對照組一次穿刺成功者為206例（88.79%），兩組比較差異有統計學意義（P＜0.05）；護士對留置針使用滿意度明顯高于一次性靜脈輸液針；患者及家屬對留置針在保持靜脈通道通暢、輸液肢體舒適的滿意度較一次性靜脈輸液針高。 結論 靜脈留置針在院前急救中能提高醫患雙方的滿意度，值得推廣使用。
Internet of Things (IoT) technology plays an important role in smart healthcare. This paper discusses IoT solution for emergency medical devices in hospitals. Based on the cloud-edge-device architecture, different medical devices were connected; Streaming data were parsed, distributed, and computed at the edge nodes; Data were stored, analyzed and visualized in the cloud nodes. The IoT system has been working steadily for nearly 20 months since it run in the emergency department in January 2021. Through preliminary analysis with collected data, IoT performance testing and development of early warning model, the feasibility and reliability of the in-hospital emergency medical devices IoT was verified, which can collect data for a long time on a large scale and support the development and deployment of machine learning models. The paper ends with an outlook on medical device data exchange and wireless transmission in the IoT of emergency medical devices, the connection of emergency equipment inside and outside the hospital, and the next step of analyzing IoT data to develop emergency intelligent IoT applications.
Interfacility transport of critically ill children is an important part of pre-hospital emergency care. The development of 5th generation mobile networks has brought revolutionary changes to emergency medicine, which can realize real-time sharing of information between hospitals and transfer ambulance units. In order to give full play to the advantages of superior medical institutions in diagnosis and treatment technology, equipment resources, and realize the safe and fast transfer of critically ill children, the technical specifications for the construction of interfacility transport of critically ill children’s ambulances with 5th generation mobile networks are specially formulated to standardize the team building, equipment and materials, transport process and quality control requirements for critically ill children’s ambulance transport, so as to reduce the fatality rate of critically ill children and improve the prognosis.
【摘要】 目的 分析地市級急救中心院前急救中損傷患者臨床特點，科學地指導院前急救診斷處置及急診外科資源配置。 方法 回顧性分析2009年1-12月份自貢市急救中心出診的全部有效病例中損傷患者出診資料，分析其疾病譜、季節、月份、時刻分布特點。 結果 全年院前急救損傷患者共1 922例，排名前5位的分別為:頭部損傷，涉及身體多個部位的損傷，膝和小腿損傷，腹部、背、腰椎和骨盆損傷，髖和大腿損傷，所有分類構成比男性均多于女性；損傷季節分布以冬季較多（Plt;0.05）；分布以1、11、12月份為多；時刻分布以凌晨0:00~6:00為出診最少時段。 結論 國際疾病分類（ICD-10）為規范院前急救疾病譜提供參考，根據損傷類疾病譜可確定急診外科工作及發展重心，依據季節、月份及時刻分布特點能指導急救資源合理配置。【Abstract】 Objective To provide scientific guidance of assistances for patients sustaining injuries and of effective resource allocation of emergency surgery by analyzing the pre-hospital features of injuries in urgent rescue centers at the local or city level. Methods All cases of injuries in pre-hospital emergency care during the year of 2009 were studied. The spectrum of diseases, and the seasons, the months, and the time points of the diseases were analyzed. Results There were totally 1 922 patients of pre-hospital emergency care in the whole year. Based on the International Classification of Diseases 10th Revision (ICD-10), top five classifications were injuries to the head, injuries involving multiple body regions, injuries to the knee and lower leg, injuries to the abdomen, lower back, lumbar spine and pelvis, and injuries to the hip and thigh. For all kinds of injuries, the number of male patients was more than that of the female. The cases in winter were more than those in other seasons (Plt;0.05). The cases in January, November and December were more than those in other months. The cases between 0:00 am and 6:00 am were less than those at other time points. Conclusion ICD-10 could provide reference for standardizing the spectrum of diseases in pre-hospital care. The focus of emergency surgery may be guided by the spectrum of injuries. The features of the season, the month, and time point of diseases can offer practical help for resource allocation in pre-hospital care.
目的 研究汶川地震后精神傷害對院前急救的影響。 方法 對2010年10月1日－2012年10月31日院前急救患者的地震后家庭成員狀況、精神傷害情況及病情程度進行回顧性病例對照分析。共有446例患者納入研究，男278例，女188例；年齡（41.4 ± 2.8）歲。依據家庭成員遇難狀況分3組，A組（家庭成員在地震中遇難）25例，B組（家庭成員在地震中受傷，無遇難情況）127例，C組（地震家庭成員完好）314例。 結果 各組患者最常見的精神傷害狀況是焦慮（A組96.0%，B組71.7%，C組40.8%）、過度警惕（A組92.0%，B組70.9%，C組50.0%），差異有統計學意義（P＜0.001）。A組患者要求到上級醫院繼續治療率較高（A組56.0%，B組39.4%，C組8.9%），組間差異有統計學意義（P＜0.001）。 結論 地震給人們的精神創傷較重，至今仍然普遍存在，并對患者的就醫活動產生影響。提示在北川縣院前急救工作中需要考慮患者的精神傷害情況。