急诊分诊创伤评估法应用研究

Application of trauma assessing method to a emergency triage

目的为了探讨对急诊创伤患者的快速有效评估方法，以防预检分诊时的漏检和误检，延误创伤患者救治。方法于2006年1月1日至2006年12月31日，采用创伤评估法，即CRAMS评分和创伤评估程序相结合，应用于浙江大学医学院附属第二医院收治的4023例创伤患者的评估。结果CRAMS〈7分（为重伤）：2430例；创伤评估程序发现有危及生命的解剖部位伤1979例；值得重视的是：采用创伤评估法发现，在CRAMS≥7分的1593例创伤患者中，仍存在危及生命伤46例。结论CRAMS法可作为类选；创伤评估程序可作解剖部位损伤的评估；二者结合而成的创伤评估法能弥补相互的缺陷，既能保证重伤患者及时有效的抢救，同时又可合理利用急诊资源。

Objective To study a quick and effective assessing method used in the emergency trauma patients in order to prevent delaying treatment for patients from overlook or misdiagnosis during triage. Method From 1 January 2006 to 31 September 2006, there were 4023 patients evaluated with trauma assessment method, which was composed of CRAMS scale and trauma assessment program. Results Of 4023 patients, there were 2430 cases with CRAMS below 7 （ 〈 7）, of whom 1979 cases assessed with trauma assessment program were found to be injuried severely to threaten their lives. And more noticeably, of 1593 patients with CRAMS≥ 7 there were 46 patients found to have life-threatening injuries assessed with trauma assessment method. Conclutions CRAMS score can be used for triage, and trauma assessment program can be used to evaluate the injuries anatomically. Trauma assessment program and CRAMS employed conjointly can increase the sensitivity and specificity for the stratification of the severity in the injuried patients in order to get a successful triage and to take advantage of the resources of emergency care appropriately.