无缝衔接一体化急救模式对山区县级基层医院急诊患者急救时效性的影响

The impact of seamless and integrated emergency mode on the timeliness of emergency treatment for severe trauma patients in county-level hospitals in mountainous areas

目的分析无缝衔接一体化急救模式在山区县级基层医院对急诊重症创伤患者急救时效性中的影响。方法选择2020年8月—2021年8月于丰都县级基层医院急诊科收治的重症创伤患者120例,其中2020年8月—2020年12月收治的重症创伤患者为常规组(常规急救模式,n=60),2021年1月—2021年8月收治的重症创伤患者为一体化组(无缝衔接一体化急救模式,n=60),比较两种急救模式院内评估至确诊时间、急诊抢救时间、专业会诊时间、有效治疗时间、抢救成功率及治愈率,密切关注患者病情变化,比较两种急救模式院内转运不良事件发生率、并发症总发生率,比较两种急救模式患者远期预后及总满意度。结果一体化组患者院内评估至确诊时间、急诊抢救时间、专业会诊时间、有效治疗时间明显低于常规组(P<0.05)。常规组、一体化组患者抢救成功率分别为86.67%、96.67%,治愈率分别为43.33%、63.33%,一体化组患者抢救成功率、治愈率明显高于常规组(P<0.05)。常规组、一体化组患者院内转运不良事件发生率分别为16.67%、5.00%,并发症总发生率分别为41.67%、18.33%,一体化组患者院内转运不良事件发生率、并发症总发生率明显低于常规组(P<0.05)。一体化组患者远期预后中、重度残疾、植物人占比明显低于常规组(P<0.05)。常规组、一体化组患者总满意度分别为78.33%、93.33%,一体化组患者总满意度明显高于常规组(P<0.05)。结论无缝衔接一体化急救模式可大大提高山区县级基层医院急诊抢救的时效性,提高救治成功率及治愈率,降低不良事件及并发症发生风险,可提高患者护理满意度,可推广参与急诊科的运行。

Objective Analyze the impact of seamless and integrated emergency mode on the timeliness of emergency treatment for severe trauma patients in county-level hospitals in mountainous areas.Methods 120 severe trauma patients admitted to the emergency department of a county-level hospital in Fengdu from August 2020 to August 2021 were selected as the routine group(conventional emergency mode,n=60),and the severe trauma patients admitted from January 2021 to August 2021 were selected as the integrated group(seamless integration of integrated emergency mode,n=60).The hospital evaluation to diagnosis,emergency rescue time,and emergency rescue time of the two emergency modes were compared Professional consultation time,effective treatment time,rescue success rate and cure rate,closely monitor the changes in patient condition,compare the incidence of adverse events and total complications during hospital transportation between the two emergency modes,and compare the long-term prognosis and overall satisfaction of patients under the two emergency modes.Results The time from in-hospital evaluation to diagnosis,emergency rescue,professional consultation and effective treatment in the integrated group were significantly shorter than those in the routine group(P<0.05).The rescue success rate and cure rate of patients in routine group and integrated group were 86.67%and 96.67%respectively,and 43.33%and 63.33%respectively.The rescue success rate and cure rate of patients in integrated group were significantly higher than those in routine group(P<0.05).The incidence of adverse transport events and complications in the conventional group and the integrated group were 16.67%and 5.00%respectively,and the total incidence of complications was 41.67%and 18.33%respectively.The incidence of adverse transport events and complications in the integrated group was significantly lower than that in the conventional group(P<0.05).The proportion of patients with moderate and severe disability and vegetative state in the long-term prognosis in the integrated group was significantly lower than that in the conventional group(P<0.05).The total satisfaction of patients in routine group and integrated group was 78.33%and 93.33%respectively,and the total satisfaction of patients in integrated group was significantly higher than that in routine group(P<0.05).Conclusion The seamless integrated first aid mode can greatly improve the timeliness of emergency rescue in county level primary hospitals in mountainous areas,improve the success rate and cure rate,reduce the risk of adverse events and complications,improve patients'nursing satisfaction,and can be popularized to participate in the operation of emergency departments.