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目的探讨改良创伤评估法在海上救治分类中的作用。方法采用改良的院前创伤评估法(即改良CRAMS评分)用于批量伤病员的急救分诊,即在评估CRAMS(循环,circulation;呼吸,respiration;胸腹部,abdomen;运动,motor;语言,speech)的同时,增加尿量、瞳孔两项指标,用于全身伤情综合评估,分别比较标准CRAMS和改良CRAMS创伤评估法与院内伤情的创伤严重程度特征评价方法(a severity characterization of trauma,ASCOT)评估法的一致性。结果标准CRAMS创伤评估法和改良CRAMS创伤评估法与院内伤情评估的ASCOT评估法都有较好的一致性(Kappa=0.821,P<0.05;Kappa=0.947,P<0.05),且改良CRAMS伤情评估法的准确性要高于标准CRAMS评估法。结论改良CRAMS创伤评估法是一种更精确的院前创伤评估法,可有效降低海上医疗救治中创伤患者的病死率,提高抢救成功率,值得推广应用。
Objective To explore the role of modified trauma assessment in the classification of treatment at sea. Methods A modified prehospital injury assessment (CRAMS) was used in the first triage of batches of critically ill patients, ie CRAMS (circulatory, circulatory; respiration, respiration; chest, abdomen, motor, language, speech, at the same time, increase urine output, pupil two indicators for the comprehensive assessment of general injury, respectively, compared CRAMS and improved CRAMS trauma assessment and hospital trauma severity trait evaluation method (a severity characterization of trauma, ASCOT) assessment of the law of consistency. Results The standard CRAMS trauma assessment method and modified CRAMS trauma assessment method had good agreement with ASCOT assessment of intra-hospital injury evaluation (Kappa = 0.821, P <0.05; Kappa = 0.947, P <0.05) The accuracy of the emotion assessment method is higher than that of the standard CRAMS assessment method. Conclusion The improved CRAMS trauma assessment method is a more accurate evaluation method of prehospital trauma, which can effectively reduce the mortality rate of trauma patients in maritime medical treatment and improve the success rate of salvage. It is worth popularizing and applying.