降阶梯思维模式对主动脉夹层患者“急诊救治链”院内抢救时效的影响

The influence of the de-escalation thinking mode on the emergency treatment timeliness of patients with aortic dissection

目的探讨降阶梯思维模式对主动脉夹层患者"急诊救治链"院内抢救时效的影响结果。方法选取2018年01月~2020年02月间我院急诊科接诊的主动脉夹层患者110例,将其中接受多学科合作的"急诊救治链"下常规护理急救干预的56例患者设为对照组,另外44例接受"急诊救治链"及降阶梯思维模式下护理急救干预的患者设为观察组。对比两组患者院内抢救时效,包括急救情况(预警及、确诊、转运及总抢救时间)、抢救成功率及急救护理满意度。结果观察组患者平均院内预警时间(4.32±1.25)min、评估及分诊时间(4.12±0.58)min、确诊时间(22.45±2.14),转运时间(6.54±1.54)min;对照组平均院内预警时间(6.33±1.36)min、评估及分诊时间(6.33±0.64)、确诊时间(28.38±3.06),转运时间(9.12±1.38)min;观察组平均院内预警时间、评估及分诊时间、确诊时间、转运时间均明显短于对照组(P<0.05)。观察组院内死亡率明显低于对照组,抢救成功率及急救护理满意度明显高于对照组(P<0.05)。结论"急诊救治链"及降阶梯思维模式下护理急救干预,可明显缩短主动脉夹层患者院内预警及评估、确诊及抢救时间,提高抢救时效和急救护理满意度,值得推广应用。

Objective To explore the effect of the de-escalation thinking model on the emergency treatment timeliness of patients with aortic dissection in the"emergency care chain".Methods A total of 110 patients with aortic dissection received in the emergency department of our hospital from January 2018 to February 2020 were selected,among which 56 patients who received routine care and emergency intervention under the multidisciplinary cooperation"emergency care chain"were set as the control group In addition,44 patients who received emergency care intervention under the"emergency care chain"and de-escalation thinking mode were set as the observation group.The timeliness of in-hospital rescue of the two groups of patients were compared,including first aid status(early warning,diagnosis,transfer and total rescue time),rescue success rate and first aid nursing satisfaction.Results The average in-hospital warning time of patients in the observation group was(4.32±1.25)min,the evaluation and triage time(4.12±0.58)min,the diagnosis time(22.45±2.14),and the transit time(6.54±1.54)min;the average inhospital warning time of the control group(6.33±1.36)min,evaluation and triage time(6.33±0.64),diagnosis time(28.38±3.06),transit time(9.12±1.38)min;the observation group’s average in-hospital warning time,evaluation and triage time,diagnosis time,The transit time was significantly shorter than that of the control group(P<0.05).The in-hospital mortality rate of the observation group was significantly lower than that of the control group,and the rescue success rate and satisfaction degree of emergency care were significantly higher than that of the control group(P<0.05).Conclusion Nursing first aid intervention under the"emergency treatment chain"and de-escalation thinking mode can significantly shorten the time for early warning and evaluation,diagnosis and rescue of patients with aortic dissection,and improve the timeliness of rescue and first aid nursing satisfaction.It is worthy of promotion and application.