严重创伤患者院内急救多学科团队的建立及临床效果

Emergency medical team improves the efficiency in severely traumatic accidents in emergency department

目的 探讨院内紧急医疗团队(EMT)模式对严重创伤患者的救治效率。方法 纳入北京积水潭医院急诊2021年12月至2022年4月采用EMT模式(EMT组)和根据损伤严重程度评分(ISS)匹配的2021年7月至11月采取传统会诊模式(传统组)诊疗的严重创伤患者各10例。对两组的呼叫急救医生时间、急救医生到达时间、急诊检查时间和抢救成功率进行回顾性分析和比较。采用SPSS 25.0软件对数据进行统计学分析。结果 两组患者的性别分布、年龄、受伤机制、到院格拉斯哥昏迷指数(GCS)、创伤指数(TI)和ISS评分差异均无统计学意义,有可比性。EMT组呼叫急救医生时间和急救医生到达时间3.4(3.0,3.9)min和10.5(6.5,12.0)min均显著少于传统组8.9(7.2,11.3)min和19.5(14.7,22.8)min,差异均有统计学意义(均P<0.001)。EMT组急诊检查时间38.5(31.8,40.0)min较传统组89.0(80.2,91.8)min减少56.7%(P<0.001)。抢救成功率EMT组为90%,传统组为70%,差异无统计学意义(P=0.582)。结论 在严重创伤患者急救中,相较于传统会诊模式,采用EMT模式能够显著提高救治效率。

Objective To explore the efficacy of Emergency Medical Team(EMT)in severely traumatic accidents in Emergency Department.Methods Ten cases of severe trauma treated under EMT model in Department of Emergency,Beijing Jishuitan Hospital from December 2021 to April 2022 were retrospectively reviewed as the EMT group.According to the injury severity score(ISS)of patients in EMT group,10 cases undergoing traditional consulting model between July and November 2021 served as the control group.The physician-calling time,physician-reaching time and the testing time in Emergency Department and success rate of rescue were compared between the 2 groups.Results A significantly shorter time was seen in the EMT group than that in the control group in terms of the physician-calling and reaching time[3.4(3.0,3.9)min vs.8.9(7.2,11.3)min;10.5(6.5,12.0)min vs.19.5(14.7,22.8)min;P<0.001,respectively].Regarding the testing time,EMT group spent 56.7%less time than the control group,and the difference was statistically significant[38.5(31.8,40.0)min vs.89.0(80.2,91.8)min,P<0.001].Conclusion Compared with the traditional consulting model,the EMT model can greatly improve the efficiency in the severe trauma accidents in the Emergency Department.