优化急危重症患者院前院内急救流程的实践与探讨

Practice and Discussion on Optimization of First Aid Process for Critical Patients in Hospital

目的缩短急危重症患者院前急救救治时间,改善急救治疗效果。方法利用价值流方法分析院前急救过程中存在的问题,采用ECRS进行优化,并对比流程优化前后的救治效果。结果优化后急性缺血性脑卒中溶栓患者入院至静脉溶栓的时间,血管内治疗患者发病至股动脉穿刺成功得时间短于优化前,90天m RS评分≤2分占比高于优化前,急性心肌梗塞患者入院至冠状动脉开通时间短于优化前,严重创伤患者到上级医院急诊停留时间短于优化前,差异有统计学意义(p<0.05)。结论优化后的院前急救流程能缩短急救时间,改善急性缺血性脑卒中患者的救治效果。

Objective To shorten the time of pre-hospital first aid for critically ill patients and improve the effect of first aid. Methods The value stream method was used to analyze the problems in the pre-hospital first aid process, and ECRS was used to optimize the process, and the treatment effect before and after the process optimization was compared. Results After optimization, the time from admission to intravenous thrombolysis in patients with acute ischemic stroke, the time from onset of endovascular therapy to successful femoral artery puncture were shorter than before, and the proportion of mRS≤2 in 90 days was higher than before. The time from admission to coronary artery opening of patients with acute myocardial infarction was shorter than before. The emergency stay in higher level hospital for severe trauma patients was shorter than before, and the difference was statistically significant(p<0.05). Conclusion The optimized pre-hospital first aid procedure can shorten the first aid time and improve the treatment effect of acute ischemic stroke patients.