Day surgery wards have advantages such as the ability to quickly free up beds and possessing necessary medical resources, making them a focal department for the integration of emergency and routine medical care within healthcare institutions. The Day Surgery Nursing Committee of Sichuan Tianfu New Area Medical Association gathered experts from relevant fields, took into account the actual situation and previous practices of integrating emergency and routine medical care in day surgery wards, and developed this expert consensus. It covers the aspects of emergency plans, process mechanisms, spatial preparations, personnel preparations and deployment, material preparations, and information sharing and coordination of the management model of integrating emergency and routine medical care in day surgery wards, so as to provide professional guidance and references for the management model of integrating emergency and routine medical care in day surgery wards, and offer new ideas and methods to maximize patient treatment during emergency situations.
After 5?12 When Chuan earthquake,The third hospital of Mianyang which is the nearest hospital of severely afflicted area recived 1 804 wounded persons.We aimed to summarize the achievement and limitation in management of medical rescue, medical treatment of the wounded and logistical support. Hospital shouled set up a special medical rescue system to relieve the sufferings of victims of unexpected natural calamities which include staff training, reserve supplies,psychological intervention of the wounded and safeguard of the rescuers.
ObjectiveTo evaluate safety and effectiveness of stent placement and emergency surgery in treatment of proximal colon cancer obstruction.MethodsThe PubMed, Embase, Cochrane Library, ClinicalTrials, CNKI, CBM, Wanfang Data, etc. were searched comprehensively. The literatures of Chinese and English randomized controlled trial and retrospective comparative study of stent placement and emergency surgery for the proximal colon cancer obstruction were retrieved. The RevMan 5.3 and Stata 12.0 softwares were used. The meta-analysis was made on the safety and effectiveness of these two treatments.ResultsA total of 9 literatures involving 636 patients were included, all of them were the retrospective studies, 4 of them only reported the clinical success rate and technical success rate. The technical success rate of stent placement was 0.94 [95% CI (0.91, 0.96)]. The clinical success rate was 0.90 [95% CI (0.87, 0.93)]. Compared with the emergency surgery group, the total complication rate and the temporary stoma rate were lower [OR=0.32, 95% CI (0.11, 0.94), P=0.04; OR=0.18, 95% CI (0.05, 0.65), P=0.009] and the hospital stay was shorter [MD=–2.97, 95% CI (–4.52, –1.41), P=0.000 2] in the stent placement group. The perioperative mortality rate, laparoscopic surgery rate, 5-year disease-free survival rate, and 5-year overall survival rate had no significant differences between these two groups (P>0.05).ConclusionCompared with emergency surgery, endoscopic stent placement for treatment of proximal colon cancer obstruction has a lower incidence of complications, temporary colostomy rate, shorter hospital stay, and it has no significant differences in mortality, laparoscopic surgery rate, and survival rate.
摘要:目的:探討基層醫院開展急診經皮冠狀動脈支架植入術(PCI)治療急性心肌梗死(AMI)的可行性、安全性。方法:回顧分析2002年11月~2009年4月我院41例AMI患者的急診PCI資料。結果:41例AMI患者,急診開通梗死相關動脈(IRA)39例(即時成功率95.1%),開通IRA者中術后死亡2例(死亡率4.9%),總成功率90.2％。結論:在有條件的基層醫院開展急診PCI安全有效。Abstract: Objective: To explore the feasibility and safety of primary percutaneous coronary intervention in patients with acute myocardial infarction in elementary hospital. Methods: The clinical data of 41 AMI patients who underwent emergent PCI from November 2002 to April 2009 were retrospectively analyzed. Results: Among the 41 AMI patients referred to PCI, infarctrelated arteries were recanalized in 39 cases. The immediate success rate was 95.1%. 2 cases of them died. The total success rate was 90.2%.Conclusion: Emergent PCI is safe and effective in the hospitals which could carry out PCI.
With the change of COVID-19, the prevention and control of COVID-19 infection epidemic entered a new stage in December 2022. How to quickly complete the emergency treatment of a large number of patients in a short period of time, and ensure that patients in emergency department can get rapid and effective medical treatment has always been an urgent problem that emergency department need to solve. The Department of Emergency Medicine of West China Hospital of Sichuan University has adopted patient-oriented management measures based on the core idea of the new public management theory, and has achieved remarkable results. Therefore, this article summarizes the workflow and nursing management strategies of the emergency department rescue area of West China Hospital of Sichuan University in dealing with the batch treatment of COVID-19 infected patients, including optimizing and correcting the environment layout of the ward, implementing the “secondary triage” mode in the rescue area, adding an inter-hospital referral platform for critical patients with COVID-19 emergency, building a conventional COVID-19 reserve material repository in the emergency department, setting up a field office for multi-department joint emergency admission service, optimizing emergency transport services for patients with COVID-19, scientific scheduling and reasonable human resource management, and providing humanistic care for employees, in order to provide reference for the management practice of the emergency department.
Objective To accurately predict the outpatient and emergency visits of a district-level public hospital based on autoregressive integrated moving average (ARIMA) model, providing important basis for hospital budget planning and operational decisions. Methods The monthly outpatient and emergency visits of a public hospital in Shuangliu District, Chengdu City from January 2012 to November 2023 were collected, and R 4.3.1 software was used to establish an ARIMA model based on the data from January 2012 to December 2022. The outpatient and emergency visits from January to November 2023 were predicted and validated. Results Except for January and March 2023, every monthly number of predicted outpatient and emergency visits for 2023 matched the actual one relatively well. The average absolute percentage error for January to November 2023 was 8.504%. The actual total number of outpatient and emergency visits from January to November 2023 was 1441960, and the predicted value was 1417130 with a relative error of –1.722%. Conclusions ARIMA model can predict the outpatient and emergency visits of district-level hospitals relatively well. However, factors such as the high incidence of COVID-19 may affect the accuracy of short-term prediction.
ObjectiveTo investigate the correlation between rapid emergency medicine score (REMS) and therapeutic intervention scoring system (TISS-28) score and analyze the feasibility of assessing the nursing workload by REMS score for critically wounded earthquake victims, in order to provide reference for rapid and effective resource allocation for earthquake victims.
MethodsA retrospective analysis was carried out on 39 Lushan earthquake victims with their acute plysiology and chronic health evaluationⅡ scores higher than 25, who were directly transferred from the earthquake site to the Emergency Department of West China Hospital between April 20 and 27, 2013. Among them, there were 24 males and 15 females aged between 5 and 90 years old averaging (57.1±19.8) years. REMS score and TISS-28 score were calculated for each victim. The relationship between REMS score and TISS-28 score was analyzed by correlation analysis and curve estimation including linear model, quadratic model, composite model, growth model, logarithm model, cubic model and exponential model. Then, we tried to find out the most suitable description for the relationship between REMS score and TISS-28 score.
ResultsThe Spearman correlation coefficient between the two score systems was 0.710 and the most suitable description for the relationship between REMS score and TISS-28 score was logarithmic curve model. The formula was TISS=-5.946+4.467lnREMS.
ConclusionREMS score can be applied as a nursing workload predicting tool for critically wounded victims in Lushan earthquake and it provides a guidance for rational allocation of health resources.
Improving the quality of infection management in outpatient and emergency departments is crucial for ensuring medical safety and advancing infection control practices. To enhance the level of infection management in outpatient and emergency departments, Tengzhou Central People’s Hospital developed a two round risk assessment system for outpatient and emergency departments hospital infection management using risk matrix and failure mode and effects analysis methods, including hospital-outpatient and emergency departments, very high risk outpatient and emergency departments-high risk point. Based on the enterprise risk management integration framework, the risk management system has been optimized to provide decision support for the prevention and control of outpatient and emergency departments hospital infection. This article will introduce the practical exploration experience of optimizing management in outpatient and emergency departments hospital infection based on risk assessment.
ObjectiveTo acquire the flow law of outpatient and emergency visits in a large general hospital.
MethodsBy sampling monthly amount of outpatient and emergency from January 2005 to December 2013 of a large general hospital in Guangzhou, the trend of the time series was analyzed and calculated the seasonal index of the amount of hospital outpatient and emergency visits with the use of long-term trends method.
ResultThe flow law of patients in the hospital outpatient and emergency was significantly affected by seasonal factors, and different month had its own variation characters. The seasonal indexes were the highest in March, July, August, November and December (seasonal index >105%), while the lowest in January, February, October (seasonal index <95%).
ConclusionBased on analysis of the outpatient and emergency visits and causes with hospitals, decision makers and hospitals should make reasonable allocation of medical resources and provide evidence for the scientific decisions of hospital management. Thus, ensure the safety of patients.
Objective To use Kaiser model, three-dimensional risk matrix and Borda ordinal value method comprehensively to analyze the vulnerability of disasters, and identify the key prevention and control risks of the hospital. Methods From June to December 2020, a disaster vulnerability analysis was conducted on a tertiary hospital in southwest China. The risk event evaluation index system was established by referring to the Kaiser model, and the evaluation indexes were classified into three aspects: possibility, controllability and harmfulness. The three-dimensional risk matrix was used to calculate the risk score to determine the risk level. The Borda ordinal value was used to compare the ranking of risk events in the same risk level. Result “Violent medical injuries” “terrorist attacks” and “explosions” were the highest ranked risk events, which needed to be prioritized and targeted for improvement. Conclusions Disaster vulnerability analysis is an important means of emergency management in hospitals. Managers should dynamically assess hospital risks, take effective preventive measures for high-risk events, conduct emergency plan drills, continuously improve risk warning mechanisms, and enhance emergency management capabilities.
