ObjectiveTo investigate the epidemiological situation of pre-hospital emergency elderly and non-elderly patients in Chengdu and explore the characteristics of pre-hospital care in the city.MethodAll pre-hospital care records in the Chengdu 120 Emergency System Database in 2017 were retrospectively collected. According to the age of the patients, they were divided into the elderly group (≥60 years old) and the non-elderly group (<60 years old). The disease spectrum, the trends of the number of emergency help calls, the changes in different diseases over time, as well as the disease composition of the patients who died in the two groups were compared.ResultsA total of 179 387 pre-hospital emergency patients were enrolled, including 59 980 elderly patients and 119 407 non-elderly patients. Most of them were male patients in both groups. Patients in the elderly group were mainly between 60 to 89 years old, and the ones in the non-elderly group were mainly between 18 to 59 years old. The pre-hospital emergency patients in the elderly group presented with trauma, nervous system, symptoms and signs, and cardiovascular system diseases mainly, accounting for 29.19%, 14.64%, 13.82%, and 12.86%, respectively. In the non-elderly group, trauma, acute poisoning, and symptoms and signs were predominant, accounting for 50.89%, 10.98%, and 10.08%, respectively. Among the pre-hospital deaths, the number in the elderly group was the larger, accounting for 69.61% (7 043 cases); the mortality rate was 11.74%, with sudden death (28.70%), cardiovascular diseases (25.95%), and respiratory diseases (16.07%) being the major causes. The pre-hospital mortality rate of non-elderly patients was 2.58%, mainly including traumatic diseases (35.41%), sudden death (unknown cause of death) (25.33%), and cardiovascular diseases (17.56%). The number of emergency help calls in the elderly group began to increase gradually from September, reaching a peak in December and hitting the trough in February. While in the non-elderly group, the peak of the emergency help calls appeared in July, and it also fell to the lowest in February. The proportion of the number of emergency help calls in the elderly group was higher in January to February and October to December; while the peak in non-elderly group was in July. The number of emergency help calls in the elderly group were mainly concentrated in the daytime (08:00 to 20:00). In the non-elderly group, the changes in the number of emergency help calls were similar to that of the elderly, however, with another peak (20:00 to 24:00). The proportion of the number of emergency help calls in the elderly group was 06:00 to 09:59, and the peak time of the non-elderly group was in the early morning (00:00 to 04:59) and night (20:00 to 23:59).ConclusionsThe number of pre-hospital care for elderly and non-elderly patients has its own characteristics in terms of the time and the distribution of disease spectrum. Trauma and cardiovascular diseases are the most common causes of pre-hospital care and death in Chengdu. And the pre-hospital mortality in the elderly group is much larger than that in non-elderly group. Relevant departments can allocate emergency resources rationally, and focus on improving the on-site rescue capacity towards related diseases.
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。
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.
目的 總結軀干及肢體大血管損傷救治的經驗體會。 方法 對37例軀干及四肢大血管損傷病例資料進行回顧性分析,總結其院前急救、手術方法和圍手術期處理經驗。結果 全組病例中除2例因失血性休克死亡外,其余病例均痊愈,無血管損傷術后并發癥。結論 加強基層醫院醫生在軀干及四肢大血管創傷救治技術上的培訓并得以提高,有利于降低大血管損傷的死亡率和致殘率。
ObjectiveTo investigate the disinfection effect of dry-fogging hydrogen peroxide (DFHP) on ambulance inner surfaces.MethodsThis study was carried out using simulated field test and field test from October to December 2018. In the simulated field test, the carriers with Geobacillus stearothemopilus (ATCC12980) spores were placed in 6 places in the ambulance, and disinfected for 60 minutes with DFHP of 0.38–0.72 g/m3. The carriers were cultured for up to 7 days to observe whether the bacteria were eliminated. Before and after the DFHP disinfection, the microbial sampling of the surface in the ambulance was carried out, and the colonies were counted after the cultivation.ResultsThe eliminating rate of the bacteria carriers on the uncovered surface was 100% (20/20), and that of the covered surface was 10% (1/10). The pass rate of microbial sampling was 100% (26/26).ConclusionsThe DFHP had a significant decontamination effect on the ambulance inner uncovered surfaces. The DFHP equipment is automated and their disinfecting quality is consistent, therefore it is suitable for the disinfection of ambulance inner surfaces. But the limitation of disinfection effect on covered surfaces should be avoided.
ObjectiveTo investigate the effect of pediatric medical transport network on transport and treatment for children in Sichuan province. MethodA total of 4647 pediatric patients transported to West China Second University Hospital were recruited from January 2011 and December 2013 in our study, among whom 1 948 were admitted before the establishment of the transport network (January 2011 to August 2012) and 2 699 were admitted after the establishment of the transport network (September 2012 to December 2013). Transport modes, patient disposition and fatality were analyzed to evaluate the role of transport network in the transport and treatment for pediatric patients. ResultsThe transported patients increased significantly after the establishment of transport network (an average of 97 cases increased to 169 cases per month). After transport network was established, valid communication and telephone contact also increased significantly (the proportion increased from 20.64% to 45.28%, P<0.001). There were significant differences in the composition of patients' destination after the establishment of the transport network (P<0.001). After the establishment of transport network, the patients' hospitalized rate and admission rate increased dramatically (from 17.86% to 37.53%, 12.11% to 41.13%, respectively). The fatality decreased from 6.83% to 3.04% (P<0.001). ConclusionsRegional pediatric transport network will contribute to the treatment of pediatric patients within the region, and decrease fatality.