急诊科拥挤对急诊临床实践的影响

Impact of emergency department crowding on emergency clinical practice

急诊科拥挤问题已经成为了一个世界性的危机，严重影响了急诊医疗服务质量。研究表明，拥挤的急诊科救护车转向率和未看医生离开急诊现象发生率较高，可引起急性心肌梗死、缺血性脑卒中等时间敏感性疾病治疗的延迟，导致更差的临床预后，增加临床用药错误的发生率，降低患者对急诊的满意度。另外还有资料显示，急诊科拥挤对急诊医师的培养也会产生不利影响。评估和缓解急诊科拥挤主要集中在入口环节、处置过程和出口环节三个部分，但到目前为止，还没有有效的评估和缓解策略。

Emergency department （ED） crowding represents a worldwide crisis, which may seriously affect the access and quality of health care. The most important themes include the increases of ambulance diversion and leaving without being seen, the deiays in care for time - sensitive diseases such as acute myocardial infarction and stroke. It contributes to various adverse outcomes, medical errors and low patient satisfaction. The ED crowding also influences the emergency resident training. The assessment and mitigation strategies are focus on input,throughput and output parts. However,there are no effective strategies till now.