Correlation Study of Neurotransmitter and Immune Levels in Pre-Hospital Emergency Nurses with Post-Traumatic Stress Disorder

Objective: To investigate the occurrence of PTSD in pre-hospital emergency nurses and its related factors, and to compare the differences of neurotransmitter and immune-related factors between pre-hospital emergency nurses who experienced traumatic events and those who did not develop PTSD and healthy people. How: Post-traumatic Stress Disorder Self-Rating Scale (PCL-C) tests were performed on pre-hospital emergency nurses in PTSD group, non-PTSD group and healthy control group, and the plasma monoamine neurotransmitters and serum cytokines were determined by double-antibody sandwich ABC-ELISA assay using enzyme-linked adsorption kit provided by Shanghai Xitang Biotechnology Co., Ltd. Results: 1) There were statistically significant differences in PCL-C scores between PTSD group, non-PTSD group and healthy group (p α between PTSD group, non-PTSD group and healthy group (p Conclusion: Pre-hospital emergency nurses should have early psychological intervention and guidance to reduce the occurrence of PTSD in emergency and emergency nurses.

Analysis of the Effect of Humanistic Care in the Process of Pre-Hospital Emergency Care

Objective:To explore the effectiveness of humanistic care in pre-hospital emergency care.Methods:From April 2020 to January 2021,80 pre-hospital emergency patients were studied.The patients were randomly divided into two groups:a control group(n=40),which received conventional care,and an experimental group(n=40),which received humanistic care.The effects of nursing care and psychological state were compared between the two groups.Results:The experimental group showed better nursing outcomes and a more positive psychological state compared to the control group(P<0.05).Conclusion:Humanistic care in pre-hospital emergency settings is more effective in reducing patients’anxiety and depression,enhancing the operational abilities and service attitudes of nursing staff,and increasing the emergency success rate.

An overview of the construction of emergency and pre-hospital first aid platform

To further improve the ability of pre-hospital and in-hospital collaborative treatment, strengthen emergency multidisciplinary cooperation and construct a scientific, rational and efficient emergency system, under the support of former chairman Yu Xue-zhong, Dr. Li Chun-sheng and numerous colleagues in the industry, the Emergency Medicine Society of the Chinese Medical Association appeal to us to draft Construction of Emergency and Pre-hospital Platform. Based on this background, the platform of emergency and pre-hospital first aid helps to build a 'one horizontal and one Longitudinal' treatment model, using the horizontal and longitudinal patterns to integrate emergency medical resources to satisfy the automatic information integration and intelligent analysis sharing, realizing the emergency management visualization and medical information digitization, simplifying the medical process and establishing a perfect standard for the emergent diseases, thereby ultimately achieving efficient diagnosis and scientific treatment.

Analysis of the Role of Problem-Based Independent Learning Model in Teaching Cerebral Ischemic Stroke First Aid in Emergency Medicine

Objective:To analyze the effect of using a problem-based(PBL)independent learning model in teaching cerebral ischemic stroke(CIS)first aid in emergency medicine.Methods:90 interns in the emergency department of our hospital from May 2022 to May 2023 were selected for the study.They were divided into Group A(45,conventional teaching method)and Group B(45 cases,PBL independent learning model)by randomized numerical table method to compare the effects of the two groups.Results:The teaching effect indicators and student satisfaction scores in Group B were higher than those in Group A(P<0.05).Conclusion:The use of the PBL independent learning model in the teaching of CIS first aid can significantly improve the teaching effect and student satisfaction.

Systemic analysis of pre-hospital trauma emergency treatment in Zhengzhou

Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis for effective use of first aid resources and enhance success rate of trauma emergency treatment. Methods: Retrospective analysis was conducted based on pre-hospital emergency resources of Zhengzhou Emergency Medical Rescue Center from 2007 to 2016. Results: The total number of pre-hospital emergency treatment cases was 9305687 from 2007 to 2016 in Zhengzhou, of which 418882 were trauma cases. The top five causes of injury were traffic accident injury, cutting injury, beating injury, crushing injury and falling injury. The top five emergency treatments used were oxygen, hemostasis, dressing and fixation, fluid supplementation, analgesics and sputum aspiration. According to different directions of diagnosis, the pre-hospital emergency patients were divided into four groups:emergency treatment group, emergency observation group, admission to general ward group and admission to ICU group. There was no statistical difference in the ages among the four groups (P>0.05). There were significantly statistical differences in gender composition among the four groups, with more males than females (P<0.01). Significant statistical differences also showed in CRAMS scores among the four groups (P<0.01). Before and after the training of primary trauma care, there was no significant difference in the constituent ratio of the trauma (P>0.05), but the mortality of the trauma, the average arrival time, and the mean treatment time were significantly different (P<0.01). Conclusions: The number of pre-hospital emergency trauma patients increased year by year, but the constituent ratio changed little. CRAMS score is important for the patients triage. Through the training of primary trauma care, the constituent ratio of death was reduced, and the average treatment time was shortened.

Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile Osteoporotic Vertebral Compression Fracture during Epidemic Period

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6 months and 12 months after treatment. There was no death rate, high satisfaction of pre-hospital first aid, high diagnostic accuracy, and good curative effect. None of the rescue personnel had any infection rate, and no hospital infection transmission and nosocomial cross infection occurred. Conclusion: It is the first step to safely treat patients and prevent cross infection to establish a perfect synchronous strategy of pre-hospital first aid and infection prevention and control.

Preparedness training programs improved the emergency response and crucial outcomes among nursing students:a scoping review

Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.

Value of Emergency Nursing Procedures in Improving the First Aid Efficiency and Outcomes of Comatose Patients with Cerebral Hemorrhage

Objective:To determine the application value of emergency nursing in improving the efficiency and outcomes of first aid for comatose patients with cerebral hemorrhage.Methods:Forty comatose patients with cerebral hemorrhage treated in Suzhou Hospital of Traditional Chinese Medicine from August 2018 to June 2019 were selected as the research subjects in this study;the patients were divided into two groups,a control group and a study group,by lot;the patients in the control group received nursing by conventional means,while emergency nursing procedures were provided to the patients in the study group;the efficiency of first aid and the outcomes of the two groups were compared;the application value of emergency nursing procedures was analyzed.Results:The first aid efficiency of the study group was significantly higher than that of the control group;the condition evaluation,reception time,triage time,and rescue time of the study group were significantly lower than those of the control group;the treatment outcomes of the study group were significantly better than those of the control group(P<0.05).Conclusion:Based on the results,compared with conventional nursing methods,the implementation of emergency nursing procedures for comatose patients with cerebral hemorrhage helps to improve the efficiency of first aid and the outcomes of the treatment;it has high clinical application value and is worthy of popularization as well as application in clinical practice.

Current pre-hospital traumatic brain injury management in China

BACKGROUND: Traumatic brain injury(TBI) is associated with most trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, prehospital service can signifi cantly reduce case-fatality rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China.DATA SOURCES: A literature search was conducted in January 2014 using the China National Knowledge Infrastructure(CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain herniation was extracted from the identifi ed articles.RESULTS: Of the 471 articles identified, 65 met the selection criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions.CONCLUSION: Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

Overview of the Shenzhen Emergency Medical Service Call Pattern

BACKGROUND：In Shenzhen, the Emergency Medical Service （EMS） system has been in service since 1997. This study aims to examine the operation of Shenzhen 120 EMS center and to identify the reasons of calling EMS.BACKGROUND：In this retrospective quantitative descriptive study, the data from the Shenzhen 120 EMS registry in 2011 were analyzed.RESULTS：Shenzhen 120 EMS center is a communication command center. When the number of 120 are dialed, it is forwarded to the closest appropriate hospital for ambulance dispatch. In 2011, the Shenzhen 120 EMS center received 153 160 ambulance calls, with an average of 420 calls per day. Calling emergency services was mainly due to traffic accidents. Trauma and other acute diseases constituted a majority of ambulance transports. The adult patients aged 15-60 years are the principal users of EMS. There are no recognized ＇paramedic＇ doctors and nurses. The pre-hospital emergency service is under the operation of emergency departments of hospitals. Shenzhen at present does not have specialized pre-hospital training for doctors and nurses in posttrauma management. Moreover, specialized pre-hospital training, financial support, and public health education on proper use of EMS should be emphasized.CONCLUSION：The Shenzhen 120 EMS center has its own epidemiology characteristics. Traumatic injury and traffic accident are the main reasons for calling ambulance service. In-depth study emphasizing the distribution and characteristics of trauma patients is crucial to the future development of EMS.

Feasibility study of emergency intervention for vascular injury outside the hospital

Background: Minimally invasive surgery in the field of traumatic vascular injury diagnosis and treatment has achieved good results. This study was designed to determine whether pre-hospital emergency intervention is feasible for vascular injury in a field intervention cabin under the condition of war or a disaster site.Methods: Different types of animal experiments of vascular injury intervention were performed in a field intervention cabin. Treatment capacity was evaluated by data collection, including duration of surgery, clinical evaluation, image clarity, and equipment handling. Environmental adaptability and mobility were evaluated by maneuverability and long-distance mobility.Results: A total of 56 surgeries(7 types) were performed in the field intervention cabin. Digital subtraction angiography(DSA) had good imaging performance. A total of 4800 km of long-distance mobility was performed, and all the equipment operated normally without any equipment failure. We participated in the medical service maneuver twice. The cabin unfolded and worked properly. There was no equipment damage during the medical service maneuver.Conclusion: Use of a field intervention cabin under the conditions of war or disaster is feasible for pre-hospital emergency intervention of vascular injury.

Use of Male Condoms among Adolescents with Free Access at Emergency Contraception—Study among Students from the Public Education System of the Sao Paulo, Brazil

The research conducted in public schools in Sao Paulo city, Brazil, studied the awareness and use of emergency contraception (EC) and its possible implications on the condoms use. Among the 4929 students, 55.6% had already had sex, 19.5% had got pregnant and 7.3% had had abortions. Condoms were used by 88.6% and were options for those who did not have a steady relationship. The EC was used by 30.3% after a faulty condom usage, and by the older ones, with a steady partner. It is needed to be given contraceptive alternatives to reduce the risk and provide access to other contraceptives.

Study on the Treatment Strategy of Batches of the Wounded and Partial First-Aid Procedures in Public Emergencies in Tertiary General Hospitals

Objective: The purpose is to formulate treatment strategies of batches of the wounded and partial first-aid procedures, and further improve the emergency rescue capability of hospitals. Methods: This study analyzed the emergency treatment case that we participated in. In this case, we used various means to start the emergency plan, run the emergency procedures, optimize diagnosis, treatment, and rescue procedures, mobilize medical rescue resources, provide a reference for emergency command decisions, formulate a set of coping strategies of tertiary general hospitals on public emergencies. Results: Through the scientific and effective management of our hospital, 20 wounded have been discharged from the hospital and achieved the ideal effect of zero deaths in the hospital. Conclusions: The new mode of first-aid and health emergency management on the scene of modern disaster needs to find ways to minimize the loss of life and property brought by public emergencies, integrate the various sections of modern disaster medicine, integrate a large number of international and domestic basic and clinical research achievements of disaster first-aid, and upgrade to information, digital system.

China＇s Development Aid Strategies

The article studies China＇s development assistance policy during the last decades. It shows the evolution of Chinese approach to providing foreign aid. The analysis is based on White Papers on China＇s Foreign Aid from 2011 and 2014, theoretical studies, and reports on China＇s foreign aid. From the beginning of the 21st century, China has become one of the most important emerging donors. Chinese aid is primarily provided to Africa, Latin America, Asia, and the Pacific. Depending on the region, the assistance is directed to large-scale infrastructure projects, energy facilities, or natural resource development activities. The aid is combined with investments and trade arrangements. Generally, China＇s aid programme is driven by economic, diplomatic, and strategic objectives. The rules according to which Chinese assistance is provided to developing countries differ significantly from the rules established by Development Assistance Committee （DAC） members. Aid-receiving countries do not have to fulfil strict development assistance regimes and adopt specific economic policies and targets.

持续质量改进对急诊科低年资护士急救应急能力的影响

目的:探讨持续质量改进对急诊科低年资护士急救应急能力的影响。方法:选取2022年6月—12月我院急诊科13名低年资护士作为研究对象,并实施持续质量改进,共实施6个月。比较实施前后低年资护士的急救知识、急救技能、应急能力等成绩考核情况。结果:实施持续质量改进后,低年资护士的急救理论考核成绩[(90.94±5.79)分]高于实施前[(60.14±6.88)分],急救技能考核成绩[(91.21±8.68)分]高于实施前[(55.15±3.97)分],急救应急能力考核成绩均高于实施前,差异均有统计学意义(P<0.05)。结论:持续质量改进可提高急诊科低年资护士的急救理论和急救技能水平,从而有效提高急救应急能力,不仅培养了低年资护士的综合素养,还有利于提高急诊科护理质量,具有重要的研究价值。

急诊零停顿与急危重症患者一体化救治体系建设探讨

急危重症患者的救治体系是保障人民生命健康的关键环节,本文立足科技赋能,基于胸痛、卒中、创伤、危重孕产妇、危重儿童和新生儿急诊急救五大中心建设,提出急诊零停顿管理目标,从信息管理技术一体化、移动CT和移动卒中单元应用、院前急救即时超声应用、复合手术室应用以及新型急救技术及创新手术团队应用等方面探讨实现急诊零停顿的技术与措施,以提升急危重症患者的救治能力。

中国航空医疗救护的发展与建议

航空医疗救护是航空应急救援在医疗领域的应用。利用航空器提供紧急医疗服务,为危急重症患者提供生命和健康支持,特别是在突发事件的重大伤情中,可以为患者争取黄金救援时间。基于现有文献、政府文件、调查访谈、会议交流、公开数据等开展研究,梳理中国航空医疗救护的发展历程、重要事件、经验教训、问题与对策发现,中国航空医疗救护虽有长足发展,但仍与民众需求相距较远。研究表明,中国航空医疗救护的应用场景以院间转运为主,运行模式多样,参与救护的力量多元,救护机构围绕资金、技术、战略、政策、管理等要素存在竞争。中国航空医疗救护水平与部分发达国家差距较大,存在体系不完善、程序复杂、力量薄弱、资金不足等问题。为此,建议在领导机构、经费来源、政策支持、技术资源保障等方面加强建设,在突发事件的应急救援中增加航空医疗救护能力,在医疗紧急救护中增加航空急救和转运能力。

某院急诊患者滞留原因分析与对策

目的 分析某院急诊患者滞留情况,为缓解急诊患者滞留难题提供参考。方法 回顾性分析该院2022年1月-12月急诊科患者滞留情况和滞留原因。结果 2022年1月-12月该院共有949人次急诊患者滞留超过24 h。急诊患者滞留排名前5的内科科室是神经内科、消化内科、呼吸内科、肾脏内科和心血管内科,排名前5的外科科室是神经外科、肝胆外科、心血管外科、泌尿外科和普通外科,内科科室滞留人数明显多于外科科室;滞留原因主要为:医院重症监护床位设置不足,多学科会诊不及时和急诊患者病情特殊等。结论 医院应建立多学科立体交融的现代医学管理体系,以解决急诊患者滞留问题。

基于院前120急救大数据的流行病学特征及其空间分析——以大连市为例

城市公共卫生应急管理与居民生命安全息息相关,随着大连市人口老龄化速度加快,疾病谱系也随之复杂化,居民对急救的需求与日俱增.采用2020年9月至2021年8月大连市120院前急救患者的历史大数据,筛选并分析院前急救患者的流行病学特征建立数据库,利用最近邻距离指数、核密度、缓冲区分析等方法研究大连市120院前急救患者的空间格局分布的类型和特征.通过筛选符合标准的40 551病例后,对院前急救患者进行流行病学分析,得到大连市120院前急救患者的流行病学特征:男女比例为1.13∶1,疾病高峰年龄段是老年组(病发年龄≥60岁),排除不明确诊断,病种占比前3的疾病是损伤和中毒(24.727%)、心血管系统(10.219%)、呼吸系统(9.928%),且这些疾病都主要发生在老年组.院前120急救患者在空间上多呈现集聚分布,主要集中于苍山路周围、友谊广场附近、东联路与华北路相交一带、香炉礁街、联合路两侧、中山广场附近、人民路、二七广场周围、马栏北街、西山小区附近、台山街周围.以期对指导医院急救资源合理配置以及制定有效的院前急救防控措施具有一定的参考意义.

PDCA结合情景模拟的培训模式对提高门诊急救质量的研究

目的:探讨PDCA循环管理结合情景模拟的培训模式对提高门诊突发事件急救质量的效果。方法:将2021年1月至2022年12月上海交通大学医学院附属瑞金医院北部院区门诊护士经筛选后共38名作为研究对象,其中男性1名,女性37名,平均年龄(29.89±5.62)岁。此外选取同一时期门诊突发急救事件共71例患者作为研究对象,进行回顾性分析。2022年1月前采用常规模式下的急救培训设为实施前,2022年1月后采用PDCA结合情景模拟模式(新模式)下的急救培训设为实施后,比较实施前后门诊护士急救能力(理论考试、基本操作考试、综合急救能力考试)、急救病例中的急救表现(启动时间、转运时间、急救成功率、纠纷及投诉率、满意度评分)以及自我效能感(一般自我效能量表评分)。结果:经过不同模式培训后,实施后护士急救能力中的理论考试[(89.19±6.50)分比(85.11±6.84)分]、综合急救能力考试[(87.76±6.10)分比(84.38±5.19)分]及基本操作各项技能考试成绩均优于实施前(均P<0.001);在真实急救病例中,实施后启动时间[(4.89±1.24)min比(5.56±1.19)min]、转运时间[(9.36±1.05)min比(10.24±1.26)min]、纠纷及投诉率(2.8%比17.1%)及满意度评分[(87.14±9.68)分比(81.63±11.18)分]也显著优于实施前(均P<0.05);实施后护士一般自我效能量表总评分也较实施前明显提高[(2.53±0.24)分比(2.31±0.22)分,P<0.05]。结论:采用PDCA循环管理结合情景模拟模式下的急救培训可有效提升门诊护士的急救能力和自我效能感,减少其紧张焦虑情绪,并在真实突发事件中提高急救质量,急救表现更好。