成都市某中心城区院前急救原则执行现状  

Implementation status of principles in prehospital emergency medical services in a given urban area of Chengdu City

作　　者：马林 刘知江 亢文超 廖亚莎 陈静 高艳明 孙玉芳 项涛 MA Lin;LIU Zhijiang;KANG Wenchao;LIAO Yasha;CHEN Jing;GAO Yanming;SUN Yufang;XIANG Tao(Chengdu Municipal First-Aid Command Center,Chengdu Sichuan 610041,China)

机构地区：[1]成都市急救指挥中心,四川成都610041 [2]西南交通大学附属医院/成都市第三人民医院,四川成都610031

出　　处：《中国急救复苏与灾害医学杂志》2024年第11期1441-1445,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：四川省医院协会2023年院前急救管理科研项目(编号:SCJJ16)。

摘　　要：目的 分析成都市中心城区网络医院院前急救“就近、就急、满足专业需要,兼顾患方意愿”原则的执行情况,为提升院前急救服务提供参考。方法 选择成都市某中心区域内21家网络医院近3个月内填报的10 697份院前急救电子病历和指挥中心同期受理的14 311次呼救数据等资料,分析院前急救反应时间、急救呼救满足率、院前患者转送他院率及其医院间的差异。结果 所观察区域平均呼救等待时间3(2~4)s,10 s内接听率92.30%(低于国家要求95%);平均受理派车时间97(77~125)s,平均呼救派车时间102(82~132)s;平均出车反应时间165(125~204)s,3 min出车率61.41%(低于国家要求95%),5 min出车率95.44%,专科医院平均出车反应时间长于综合医院;救护车前往现场平均路途行驶时间428(305~607)s,专科医院平均路途行驶时间是综合医院的2倍;平均急救反应时间709(562~913)s;急救呼救满足率达100%;转送他院率为21.82%,非三甲医院的转送他院率高于三甲医院。结论 成都市急救指挥中心受理呼救和派车比较及时妥当;区域内急救资源能满足日常院前急救需求;网络医院的急救团队能够做到根据病情和患方意愿合理转送患者就医。应进一步优化流程与管理,提高急救呼叫10 s接听率并缩短院前急救出车反应时间。需要继续推进公众急救的科普与宣教,提高急救资源的利用效率。Objective Giving priority to proximity and urgency,meeting the need for capability and considering the patient's willingness are well-known principles of prehospital emergency medical services(EMS).This study sought to quantitatively evaluate the implementation of these principles in a selected urban area of Chengdu city,provide references for improving local prehospital medical care quality.Methods We drew electronic prehospital records of 10697 patients for which cared by twenty-one network hospitals,located in a central area of Chengdu city,over a 3-month period( April 1 to June 30,2023),and 1-2-0 calls of 14311 emergency events occurred in the same region and period.And then,we calculated pre-hospital first aid response time,satisfying rate of need for ambulance,proportion of transport to other hospital and their differences among hospitals.All time intervals were computed using median and IQR(interquartile range).Results Median alarm ring time was 3(2-4) seconds,rate of calls received within 10 s was 92.30%,below the nationalrecommendation of ≥95%.Median time from receiving to dispatching was 97(77-125)seconds,median time from alarming to dispatching was 102(82-132) seconds.Median ambulance respond time was 165(125-204) seconds,rate of ambulance departure within 3 or 5 minutes was 61.41%,below the nationalrecommendation of ≥95% and 95.44% respectively,Longer time for specialized hospitals' ambulance to start moving was spent than general ones.Median driving time to scene was 428(305-607) seconds,with two-fold longer time in specialized hospitals compared to general ones.Total median prehospital response time was 709(562-913) seconds.Overall ambulance request satisfying rate fundamentally reached 100%.The proportion of transport by responding ambulance to other hospital was 21.82%,which was higher among non-grade Ⅲ,class A hospitals compared to grade Ⅲ,class A hospitals.Conclusion Our results indicate that Chengdu Emergency Command Center received emergency calls and dispatched vehicles in a timely an

关 键 词：院前医疗急救 医学救援管理 反应时间 网络医院 中心城区 

分 类 号：R459.7[医药卫生—急诊医学]