新冠肺炎疫情下急诊抢救患者特点及应对策略  

Characteristics of emergency critically-ill patients during coronavirus disease 2019 outbreak and the introduction of emergency department countermeasures against COVID-19

作　　者：龙锐 田俊英 杨秀华 刘春光 易源源 费军 Long Rui;Tian Jun-ying;Yang Xiu-hua;Liu Chun-guang;Yi Yuan-yuan;Fei Jun(Department of Emergency,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院急诊医学科,重庆400042 [2]重庆医科大学外国语学院医学英语教研室,重庆400016

出　　处：《中国急救医学》2020年第6期562-568,共7页Chinese Journal of Critical Care Medicine

摘　　要：目的分析新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)疫情对急诊抢救患者就诊特点的影响,总结相关规律,制定应对策略.方法采用回顾性横断面研究分析重庆市启动突发公共卫生事件Ⅰ级(特别重大)响应后1个月内及2018年、2019年同期陆军军医大学大坪医院救治的1034例急诊抢救患者的临床资料,其中男515例,女519例,年龄15~95岁[(67.5±13.5)岁],总结其病种分布特点,以及与重型和危重型COVID-19相关的临床指标,探讨急诊抢救患者就诊相关规律,制定应对策略,包括实施三级预检分诊,设置抢救过渡区,调整急诊功能布局.结果重庆市启动突发公共卫生事件Ⅰ级(特别重大)响应后1个月内急诊抢救患者例数较2018年、2019年同期均没有明显减少(P>0.05),严重创伤和急性中毒患者与2018年、2019年同期比较均明显减少(P<0.05),与重型和危重型COVID-19临床指标相关的患者例数与2018年、2019年同期比较差异均无统计学意义(P>0.05).抢救过渡区共救治COVID-19疑似病例3例,确诊0例;发热门诊抢救区共救治COVID-19疑似病例11例(不含抢救过渡区转往的3例),确诊0例.结论COVID-19疫情对急诊抢救患者就诊人数影响有限,同时,由于实施三级预检分诊、设置和运行抢救过渡区的需要,医疗机构在疫情期间应大力增加急诊医护力量.鉴于严重创伤和急性中毒患者明显减少,为提高资源利用率,可临时调整急诊科功能布局.另外,三级预检分诊能将重型和危重型COVID-19疑似患者正确引导至发热门诊抢救区,减少了急诊诊疗区其他就诊患者、家属和医务人员被感染的风险.Objective To analyze the influence of coronavirus disease 2019(COVID-19)outbreak on the visiting characteristics of emergency critically-ill patients,to summarize the relevant regularities,and to establish the countermeasures.Methods A retrospective cross-sectional analysis was conducted on the clinical data of 1034 emergency critically-ill cases admitted to Daping Hospital of Army Medical University,including 515 males and 519 females,aged 15-95 years[(67.5±13.5)years],reported over three periods(the first month in response to the First Level Great Emergent Public Health Events in Chongqing,the same period in 2018 and 2019,respectively).The distribution of disease entity and the clinical indicators of severe and critical COVID-19 as well as the visiting regularities of emergency critically-ill patients were summarized.Meanwhile,countermeasures including implementing three-level pre-examination triage,setting up rescue transition zone,and adjusting the layout of emergency functions were established.Results Within the first month in response to the First Level Great Emergent Public Health Events in Chongqing,there was neither significant reduction in the number of emergency cically-ill patients in our hospital(P>0.05),nor statistically significant difference in the number of patients with the clinical indicators of severe and eritical COVID-19(P>0.05).However,the patients with severe trauma and acute poisoning were significantly reduced as compared with the same period in 2018 or 2019(P<0.05).In our emergency rescue transition zone,3 suspected COVID-19 cases were treated,yet none was confirmed.A total of 11 suspected COVID-19 cases(didn't include the 3 cases from the emergency rescue transition zone)were treated in rescue area of fever elinie,and 0 of them were confirmed.Conclusion The epidemic of COVID-19 had lttle impact on the number of emergency critically-ill patients.In addition,it is necessary for all medical institutions to strengthen their emergency medical forces in response to the need to implement thr

关 键 词：新型冠状病毒肺炎 疫情 急诊抢救 患者特点 应对策略 

分 类 号：R459.7[医药卫生—急诊医学]