ObjectiveTo understand the pre-hospital emergency medical staff's knowledge on crush injury and crush syndrome, and the influence of active and effective pre-hospital measures on the prognosis of patients with crush injury.
MethodsWe retrospectively analyzed the clinical data of 51 patients with crush injury treated from September 2004 to August 2014, and recorded the number of cases in which pre-hospital emergency medical staff recognized and/or took effective measures to control crush syndrome. Treatment group included those patients who accepted effective prevention and control measures, and the rest of the patients were included in the control group. We compared the two groups of patients in terms of the incidence of serious complications such as crush syndrome and amputation.
ResultsTwenty-five cases (49.0%) of crush injury were recognized before the patients were admitted into the hospital, among whom 20 (39.2%) accepted effective preventive and control measures. The mangled extremity severity score between the two groups of patients had no significant difference (6.69±1.96 vs. 7.23±3.54, P>0.05). After being admitted into the hospital, the treatment group had one complication case of crush injury, while the control group had 10 complication cases including 7 of crush injury and 3 of amputation. The complication rate of the treatment group (5.0%) was significantly lower than that of the control group (32.3%, P<0.05).
ConclusionActive and effective prehospital preventive and control measures are very important in the treatment of crush syndrome and reduction of morbidity, but the pre-hospital emergency personnel's knowledge of crush injury and crush syndrome is not enough.
【摘要】 目的 分析地市級急救中心院前急救中損傷患者臨床特點，科學地指導院前急救診斷處置及急診外科資源配置。 方法 回顧性分析2009年1-12月份自貢市急救中心出診的全部有效病例中損傷患者出診資料，分析其疾病譜、季節、月份、時刻分布特點。 結果 全年院前急救損傷患者共1 922例，排名前5位的分別為:頭部損傷，涉及身體多個部位的損傷，膝和小腿損傷，腹部、背、腰椎和骨盆損傷，髖和大腿損傷，所有分類構成比男性均多于女性；損傷季節分布以冬季較多（Plt;0.05）；分布以1、11、12月份為多；時刻分布以凌晨0:00~6:00為出診最少時段。 結論 國際疾病分類（ICD-10）為規范院前急救疾病譜提供參考，根據損傷類疾病譜可確定急診外科工作及發展重心，依據季節、月份及時刻分布特點能指導急救資源合理配置。【Abstract】 Objective To provide scientific guidance of assistances for patients sustaining injuries and of effective resource allocation of emergency surgery by analyzing the pre-hospital features of injuries in urgent rescue centers at the local or city level. Methods All cases of injuries in pre-hospital emergency care during the year of 2009 were studied. The spectrum of diseases, and the seasons, the months, and the time points of the diseases were analyzed. Results There were totally 1 922 patients of pre-hospital emergency care in the whole year. Based on the International Classification of Diseases 10th Revision (ICD-10), top five classifications were injuries to the head, injuries involving multiple body regions, injuries to the knee and lower leg, injuries to the abdomen, lower back, lumbar spine and pelvis, and injuries to the hip and thigh. For all kinds of injuries, the number of male patients was more than that of the female. The cases in winter were more than those in other seasons (Plt;0.05). The cases in January, November and December were more than those in other months. The cases between 0:00 am and 6:00 am were less than those at other time points. Conclusion ICD-10 could provide reference for standardizing the spectrum of diseases in pre-hospital care. The focus of emergency surgery may be guided by the spectrum of injuries. The features of the season, the month, and time point of diseases can offer practical help for resource allocation in pre-hospital care.
【摘要】 目的 研究自貢市急救中心院前急救流行病學特征。 方法 回顧性分析2009年度自貢市急救中心出診的院前急救數據，研究院前急救疾病譜及性別、年齡構成，并分析時刻及季節分布特點，描述院前急救轉歸。 結果 2009年度自貢市急救中心院前急救共4 588例，排前6位疾病依次為損傷、中毒和外因的某些其他后果（45.6%），循環系統疾病（15.0%），呼吸系統疾病（6.3%），神經系統疾病（6.0%），精神和行為障礙（5.6%），消化系統疾病（4.9%）；性別構成男性多于女性（Plt;0.05）；年齡構成以中老年較多，青少年兒童較少（Plt;0.05）；時刻分布規律高峰點為15點40分（Plt;0.05），季節分布以冬季較多（Plt;0.05）；患者轉歸以住院、留院觀察為主，院前死亡人數占比例為3.8%。 結論 根據院前急救流行病學規律，可以合理配置急診資源，增強應急救援能力，滿足民眾不斷增加的醫療需求。【Abstract】 Objective To research on the epidemiological characteristics of the prehospital cases in Zigong emergency rescue center. Methods We retrospectively analyzed the database of prehospital cases in Zigong emergency rescue center in 2009, and reviewed the prehospital disease spectrum, gender composition, age structure, the circadian and seasonal distribution, and the outcomes of these cases. Results A total of 4 588 prehospital victims in Zigong emergency rescue center were enrolled. In the study, six leading diseases were injury, poisoning and certain other consequences due to external causes (45.6%), diseases of the circulatory system (15.0%), diseases of the respiratory system (6.3%), diseases of the nervous system (6.0%), mental and behavioral disorders (5.6%), and diseases of the digestive system (4.9%). Male patients were more than female patients (Plt;0.05). The proportion of the aged and the middle-aged was significantly larger than that of young population in the same districts (Plt;0.05), and the occurrence of prehospital care usually peaked at 15:40 (Plt;0.05). Prehospital care had a higher incidence in winter (Plt;0.05), and the outcome of prehospital cases was mainly in hospital and in observation ward. The proportion of deaths was 3.8%. Conclusion We can allocate emergency resources reasonably in prehospital care, and promote the ability of rescuing in order to meet people′s medical demands on the basis of the epidemiological study in our city.
ObjectiveTo investigate the epidemiological situation of pre-hospital emergency elderly and non-elderly patients in Chengdu and explore the characteristics of pre-hospital care in the city.MethodAll pre-hospital care records in the Chengdu 120 Emergency System Database in 2017 were retrospectively collected. According to the age of the patients, they were divided into the elderly group (≥60 years old) and the non-elderly group (<60 years old). The disease spectrum, the trends of the number of emergency help calls, the changes in different diseases over time, as well as the disease composition of the patients who died in the two groups were compared.ResultsA total of 179 387 pre-hospital emergency patients were enrolled, including 59 980 elderly patients and 119 407 non-elderly patients. Most of them were male patients in both groups. Patients in the elderly group were mainly between 60 to 89 years old, and the ones in the non-elderly group were mainly between 18 to 59 years old. The pre-hospital emergency patients in the elderly group presented with trauma, nervous system, symptoms and signs, and cardiovascular system diseases mainly, accounting for 29.19%, 14.64%, 13.82%, and 12.86%, respectively. In the non-elderly group, trauma, acute poisoning, and symptoms and signs were predominant, accounting for 50.89%, 10.98%, and 10.08%, respectively. Among the pre-hospital deaths, the number in the elderly group was the larger, accounting for 69.61% (7 043 cases); the mortality rate was 11.74%, with sudden death (28.70%), cardiovascular diseases (25.95%), and respiratory diseases (16.07%) being the major causes. The pre-hospital mortality rate of non-elderly patients was 2.58%, mainly including traumatic diseases (35.41%), sudden death (unknown cause of death) (25.33%), and cardiovascular diseases (17.56%). The number of emergency help calls in the elderly group began to increase gradually from September, reaching a peak in December and hitting the trough in February. While in the non-elderly group, the peak of the emergency help calls appeared in July, and it also fell to the lowest in February. The proportion of the number of emergency help calls in the elderly group was higher in January to February and October to December; while the peak in non-elderly group was in July. The number of emergency help calls in the elderly group were mainly concentrated in the daytime (08:00 to 20:00). In the non-elderly group, the changes in the number of emergency help calls were similar to that of the elderly, however, with another peak (20:00 to 24:00). The proportion of the number of emergency help calls in the elderly group was 06:00 to 09:59, and the peak time of the non-elderly group was in the early morning (00:00 to 04:59) and night (20:00 to 23:59).ConclusionsThe number of pre-hospital care for elderly and non-elderly patients has its own characteristics in terms of the time and the distribution of disease spectrum. Trauma and cardiovascular diseases are the most common causes of pre-hospital care and death in Chengdu. And the pre-hospital mortality in the elderly group is much larger than that in non-elderly group. Relevant departments can allocate emergency resources rationally, and focus on improving the on-site rescue capacity towards related diseases.
