基于CRAMS评分一体化分级诊疗救护模式在多发性创伤患者中的应用效果  

Application effect of integrated graded diagnosis and treatment and rescue mode based on circulation respiration abdomen motor speech score in patients with multiple trauma

作　　者：孙建华 蒋伟康 王国志 沈黎文 Sun Jianhua;Jiang Weikang;Wang Guozhi;Shen Liwen(Department of Emergency Medicine,Shanghai Sixth People's Hospital,Shanghai 200233,China)

机构地区：[1]上海市第六人民医院急诊医学科,上海手200233

出　　处：《中国中西医结合急救杂志》2024年第5期583-587,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

摘　　要：目的探讨基于循环呼吸腹部运动语言(CRAMS)评分的一体化分级诊疗救护模式在多发性创伤患者中的应用效果。方法选择2023年3月至2024年3月上海市第六人民医院急诊抢救室救治的160例多发性创伤患者为研究对象,按随机数字表法分为观察组和对照组,每组80例。对照组行急诊常规救治,观察组由干预小组应用CRAMS评分量表对患者进行病情分级评估,并根据评估结果对患者实施一体化分级诊疗救护模式,具体措施如下:成立救治干预小组,小组成员包括急诊抢救室主治医生1名,抢救室创伤专科护士组长1名,抢救室创伤专科护士3名。主治医生负责对患者病情进行诊断及治疗,创伤专科护士组长负责应用CRAMS评分量表对患者病情进行评估;创伤专科护士负责对患者实施干预。比较两组干预前后CRAMS评分、创伤严重程度(ISS)评分、分诊时间、等待救治时间、救治时间、并发症发生率及患者满意度的差异。结果干预前两组CRAMS评分、ISS评分比较差异均无统计学意义;干预后观察组CRAMS评分明显高于对照组(分:8.85土0.89比7.52±1.02,P<0.05),而ISS评分明显低于对照组(分:15.98±2.98比20.77±3.02,P<0.05)。观察组分诊时间、等待救治时间、救治时间均较对照组明显缩短[分诊时间(min):3.25土0.62比5.89±1.02,等待救治时间(min):3.02±0.45比5.78±0.98,救治时间(min):45.85±5.23比65.22±6.41,均P<0.05]。观察组并发症发生率明显低于对照组[3.75%(3/80)比12.50%(10/80)P<0.05],而满意度明显高于对照组[93.75%(75/80)比77.50%(62/80),P<0.05]。结论基于CRAMS评分的一体化分级诊疗救护模式可提高多发性创伤患者的救治效率,改善患者病情及预后,提高患者救治满意度。Objective To exploretheapplication of theintegrated graded diagnosis,treatment and ambulance model based on circulation respiration abdomen motor speech(CRAMS)score in patients with multiple traumas.Methods From March 2023 to March 2024,160 patients with multiple traumas admitted to the department of emergency of Shanghai Sixth People's Hospital were selected as the research subjects.Based on a random number table,the patients were divided into an observation group and a control group,with 80 patients in each group.And the control group received routine emergency treatment,while the observation group was assessed by the intervention team using the CRAMS scoring scale to evaluate the condition,and then implemented an integrated graded diagnosis and treatment model based on the assessment results.The specific measures were as follows:establish an intervention team composed of 1 attending doctor from the emergency resuscitation room,1I head nurse specializing in trauma care,and 3 trauma specialty nurses.The attending doctor was responsible for diagnosing and treating the patient's condition;the head nurse specializes in assessing the patient using the CRAMS scoring scale:the trauma specialty nurses were tasked with implementing interventions for the patient.The CRAMS score,injuy seveity scoe(ISS),triage time,waiting time for treatment,treatment time,complication rate,and patient satisfaction rate were compared between the two groups before and after the intervention.Results There were no significant differences in CRAMS scores and ISS scores between the two groups before intervention.After intervention,the CRAMS score of the observation group was significantly higher than that of the control group(8.85±0.89 vs.7.52±1.02,P<0.05),while the ISS score was significantly lower than that of the control group(15.98±2.98 vs.20.77±3.02,P<0.05).The triage time,waiting time for treatment,and treatment time of the observation group were significantly shorter than those of the control group[triage time(minutes):3.25±0.62 vs.

关 键 词：循环呼吸腹部运动语言评分 一体化分级诊疗救护模式 多发性创伤 救治效果 满意率 

分 类 号：R47[医药卫生—护理学]