...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Prehospital emergency care >Outcome of trauma patients immobilized by emergency department staff, but not by emergency medical services providers: A quality assurance initiative
【24h】

Outcome of trauma patients immobilized by emergency department staff, but not by emergency medical services providers: A quality assurance initiative

机译：由急诊部门的工作人员而不是急诊医疗服务提供者固定的创伤患者的结果：质量保证计划

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background. Prehospital selective cervical spine immobilization (CSI) is a relatively new concept. In our emergency medical services (EMS) system, protocols for selective CSI are widely used; yet, some patients who are brought to the hospital without CSI undergo secondary immobilization and cervical spine imaging in the emergency department (ED). Immobilization in the ED, after a decision not to immobilize by EMS, suggests that either the prehospital assessment is not trusted or the patient has developed new symptoms over time. We undertook a quality assurance initiative to evaluate whether trauma patients brought to the ED without CSI, who then underwent secondary CSI and imaging in the ED, had injuries that were initially missed by EMS selective CSI protocol.Methods. This was a 36-month retrospective data analysis of blunt trauma patients transported directly from the field to the University of New Mexico Hospital level I trauma center by Albuquerque Ambulance Service (AAS) between March 2009 and February 2012. Inclusion criteria were age 18 years and older, transported by AAS without CSI, and cervical spinal imaging done in the ED. Patients were excluded if they were being transported between facilities, were prisoners, and/or refused CSI. A positive finding was defined as any acute abnormality identified by the attending radiologist on the final imaging report.Results. The study included 101 patients who met inclusion criteria. There were no significant missed injuries. Ninety-four of the 101 patients received cervical spinal CT imaging at an estimated cost of $1,570 per scan, not including physician charges. The remaining patients had plain film radiographic imaging. No patients had magnetic resonance imaging.Conclusions. In this retrospective quality assurance initiative, none of 101 patients who underwent secondary CSI and imaging in the ED had a missed acute cervical injury. No patients had any adverse effects or required treatment, yet these patients incurred substantial costs and increased radiation exposure. While our results suggest hospital personnel should have confidence in prehospital decisions regarding CSI, continued surveillance and a large-scale, prospective study are needed to confirm our findings.
机译：背景。院前选择性颈椎固定术（CSI）是一个相对较新的概念。在我们的紧急医疗服务（EMS）系统中，选择性CSI协议得到了广泛使用。但是，一些没有CSI送入医院的患者在急诊室（ED）进行了二次固定和颈椎影像学检查。在决定不通过EMS进行固定后，将ED固定在患者身上，这表明要么不信任院前评估，要么患者随着时间的推移出现了新的症状。我们采取了一项质量保证计划，以评估没有CSI的急诊患者是否随后接受了ED的继发性CSI和影像学检查，然后被EMS选择性CSI方案遗漏。这是对2009年3月至2012年2月之间由阿尔伯克基救护车服务（AAS）直接从现场转移到新墨西哥大学医院第一级创伤中心的钝性创伤患者进行的36个月回顾性数据分析。纳入标准为18岁和较老，由ACSI运送而没有CSI，并且在ED中进行了颈椎成像。如果患者在设施之间运输，囚犯和/或拒绝CSI被排除在外。阳性发现定义为主治放射科医生在最终影像报告中发现的任何急性异常。该研究纳入了101名符合纳入标准的患者。没有重大的遗漏伤害。在101名患者中，有94名接受了颈椎CT成像，每次扫描的费用估计为1,570美元，其中不包括医师费用。其余患者进行了平片放射成像。没有患者进行磁共振成像。结论。在这项回顾性质量保证计划中，101名在急诊室接受了继发性CSI和影像学检查的患者均未漏掉急性宫颈损伤。没有患者有任何不良反应或需要治疗，但是这些患者招致了大量费用并增加了辐射暴露。虽然我们的结果表明医院工作人员应该对院前关于CSI的决定充满信心，但仍需继续进行监测，并且需要进行大规模的前瞻性研究以证实我们的发现。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号