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目的探讨急救患者死亡和伤残的原因,为进一步加强急救网络医院急诊科内涵建设提供客观依据。方法对照2002和2003年全市各急救网络医院有急诊科急救记录的870份和1260份急救死亡病历填写调查表,用Profox6·0建立数据库,分析患者到达急诊科的时间、首诊医生到现场时间、首次医嘱时间、二线医生或上级医生到场时间及患者到急诊科后的死亡时间,并采用SPSS11·0软件进行统计学处理。结果急救死亡患者到达急诊科的时间段以0∶00~08∶00最多,两年度分别为29·43%和31·10%,两年度间差别无显著性意义(P>0·05);两年度的首诊医师到场时间、首次医嘱时间的中位数均为0min,但时段分布间差别有显著性意义(P<0·05);两年度二线或上级医生到场中位时间分别为1min和0min,但时段分布间差别无显著性意义(P>0·05);两年度会诊医师到场中位时间分别为20min和5min,时段分布间差别有显著性意义(P<0·05);两年度患者到达急诊科死亡中位时间分别为55min和40min,差别有显著性意义(P<0·05)。结论监测和评估急诊科急救工作的时间因素、技术因素和质量因素等非常有必要,可依此加强管理。
Objective To explore the causes of death and disability in emergency patients and provide objective basis for further strengthening the construction of the emergency department of emergency hospital network. Methods According to the emergency records of emergency department in 870 and 1260 emergency medical records of emergency hospitals in 2002 and 2003, the questionnaire was filled in and the database was set up with Profox 6.0 to analyze the patients’ arrival time in the emergency department and the first doctor to the scene time , The time of the first doctor’s order, the arrival time of the second-line doctor or superior doctor and the time of death from the patient to the emergency department, and the data were processed by SPSS11.0 software. Results The time of emergency rescue reached emergency department from 0:00 to 08:00, with 29.43% and 31.10% in the two years respectively. There was no significant difference between the two years (P> 0.05). In the two years, the median time of the first doctor’s visit was 0min, but the time difference between the two groups was significant (P <0.05); the second-year or second-line doctor’s attendance time was 1min (P> 0.05). There was no significant difference in time distribution between the two groups (P> 0.05). The median time of two-year consultations was 20min and 5min, respectively. There was significant difference in time distribution between two groups (P <0.05) The median time to emergency department death in two years were 55 and 40 min, respectively, with significant difference (P <0.05). Conclusion It is very necessary to monitor and assess the time, emergency, technical and quality factors of EM emergency work so as to strengthen the management.