Fifty percent of the deaths caused by severe trauma occur within 1 h after injury. With the concepts ot ＂golden 1 h＂ and ＂platinum 10 rain＇, the professionals in the field of emergency trauma treatment have agreed...Fifty percent of the deaths caused by severe trauma occur within 1 h after injury. With the concepts ot ＂golden 1 h＂ and ＂platinum 10 rain＇, the professionals in the field of emergency trauma treatment have agreed on the necessity of establishing a rapid and efficient trauma rescue system. However, due to the size of the hospital, the population in the neighborhood, the local economic conditions and geographical features, how to establish an optimal trauma rescue system remains an issue. In this paper, we introduced our experiences in a county-level hospital located in middle-and high-income areas.展开更多
目的探讨多学科合作一体化急救流程在急诊严重创伤患者救治中的应用效果。方法选取2021年6月-2022年5月南华大学附属第二医院创伤中心收治的100例创伤患者为研究对象,按照入院先后顺序将2021年6-11月收治的51例患者设为对照组;2021年12...目的探讨多学科合作一体化急救流程在急诊严重创伤患者救治中的应用效果。方法选取2021年6月-2022年5月南华大学附属第二医院创伤中心收治的100例创伤患者为研究对象,按照入院先后顺序将2021年6-11月收治的51例患者设为对照组;2021年12月-2022年5月收治的49例患者设为观察组。对照组采用常规急救护理模式,观察组采用多学科合作的一体化急救流程。观察两组患者的创伤团队激活系统(Trauma Team Activation,TTA)启动时间、首次放射检查时间、急诊滞留时间、急诊至创伤手术室时间,抢救成功率以及急诊救治满意度。结果观察组患者TTA启动时间、首次放射检查时间、急诊滞留时间,急诊至创伤手术室时间均短于对照组,差异均有统计学意义(P<0.05);观察组患者抢救成功率高于对照组,差异有统计学意义(P<0.05);观察组患者对急诊救治满意程度高于对照组,差异有统计学意义(P<0.05)。结论多学科合作一体化急救流程能有效提高急诊严重创伤患者的救治成功率,改善患者的预后,提高急诊救治满意度。展开更多
为提高中医专业实习生处理急重症患者的能力,在西医外科创伤急救教学中,引进急救仿真模拟人(emergency care simulator,ECS),开展了模拟重症创伤患者真实情景的临床实习训练,与常规教学组进行了对照评价,并进行了问卷调查。结果显示,EC...为提高中医专业实习生处理急重症患者的能力,在西医外科创伤急救教学中,引进急救仿真模拟人(emergency care simulator,ECS),开展了模拟重症创伤患者真实情景的临床实习训练,与常规教学组进行了对照评价,并进行了问卷调查。结果显示,ECS培训组学生的理论考试和技能操作成绩均明显优于常规教学组(P<0.05),且学生对ECS教学给予了充分肯定和良好的评价,表明ECS训练教学可提高创伤急救的教学效果,有利于培养学生的临床判断能力和救治能力。展开更多
【目的】研究无缝隙急救护理模式对急诊创伤患者抢救的影响。【方法】采用随机数字表法将2019年1月至2019年12月于本院就诊的150例严重创伤患者分为研究组与对照组,各75例,对照组给予常规急救护理,研究组给予无缝隙急救护理模式干预。...【目的】研究无缝隙急救护理模式对急诊创伤患者抢救的影响。【方法】采用随机数字表法将2019年1月至2019年12月于本院就诊的150例严重创伤患者分为研究组与对照组,各75例,对照组给予常规急救护理,研究组给予无缝隙急救护理模式干预。统计两组各项急救时间、抢救成功率、急救不良反应事件以及救治7 d后患者Spitzer生存质量指数量表(Spitzer quality of life index,SQLI)评分。【结果】研究组患者确诊时间、急诊科停留时间、急诊到手术时间以及住院时间均明显少于对照组(P<0.05);研究组急救成功率明显高于对照组,研究组不良事件发生率明显低于对照组;研究组SQLI各项评分均高于对照组(P<0.05)。【结论】无缝隙急救护理模式应用于急诊创伤患者急救可明显缩短急救时间,降低不良事件发生率,提高急救效果。展开更多
目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和...目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和心率、体温、收缩压3项生理指标变化,并采用问卷调查的方法分析培训前后问卷调查评分变化。结果参训人员78人,其中医生64人,占82.1%,护理人员14人,占17.9%,5年以上临床工作经验参训人员占70.5%,经理论和模拟病例考核有72人通过,通过率92%。培训考核结束后体温、心率和收缩压3项生理指标均不同程度的升高(P<0.01),问卷调查培训前平均评分(50.1±3.468)分,培训后及培训后半年平均评分为(66.2±2.46)、(64.2±1.835)分,均高于培训前(P<0.01)。结论PHTLS培训能增加医护人员创伤救治知识,提高救护技术水平,增强信心,增加团队配合经验,对于军队医院医护人员战创伤救治训练有一定价值。展开更多
Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-tho...Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-thoracotomy benefits for patients with blunt traumatic hemothorax compared with conventional repair through full thoracotomy. Twenty-five patients underwent emergency operation for acute hemothorax from 2000. Five patients with less than 5% probability of survival (PS) were excluded, leaving 20 as the subjects. Results: Ten patients underwent conventional thoracotomy (conventional group) and the other 10 patients underwent VATS with mini-thoracotomy (VATS group). There was no difference between conventional group and VATS group in injury severity score (29.1 and 27.0) or PS (81.2% and 80.7%). Hospital mortality rates were 10% in conventional group and 0% in VATS group (N.S). Total amounts of intra-operative bleeding and post-operative transfusion until day 7 were 735 ml and 19.3 units in conventional group and 303 ml and 9.2 units in VATS group respectively (N.S). The length of ICU stay was 9.7 days in conventional group and 5.9 days in VATS group (N.S). Conclusion: VATS with mini-thoracotomy can be alternative for patients with blunt traumatic hemothorax in most emergency operations.展开更多
Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency su...Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income countries.To understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was envisioned.Apreviously published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this context.The novel matrix incorporates 108 variables.These variables are grossly divided into local and international agency components to address the issue of who is providing care.Using a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their intervention.In addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient safety.Pilot testing of this matrix to obtain feedback from end users is the next step in development.Ultimately,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.展开更多
The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were dire...The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.展开更多
文摘Fifty percent of the deaths caused by severe trauma occur within 1 h after injury. With the concepts ot ＂golden 1 h＂ and ＂platinum 10 rain＇, the professionals in the field of emergency trauma treatment have agreed on the necessity of establishing a rapid and efficient trauma rescue system. However, due to the size of the hospital, the population in the neighborhood, the local economic conditions and geographical features, how to establish an optimal trauma rescue system remains an issue. In this paper, we introduced our experiences in a county-level hospital located in middle-and high-income areas.
文摘目的探讨多学科合作一体化急救流程在急诊严重创伤患者救治中的应用效果。方法选取2021年6月-2022年5月南华大学附属第二医院创伤中心收治的100例创伤患者为研究对象,按照入院先后顺序将2021年6-11月收治的51例患者设为对照组;2021年12月-2022年5月收治的49例患者设为观察组。对照组采用常规急救护理模式,观察组采用多学科合作的一体化急救流程。观察两组患者的创伤团队激活系统(Trauma Team Activation,TTA)启动时间、首次放射检查时间、急诊滞留时间、急诊至创伤手术室时间,抢救成功率以及急诊救治满意度。结果观察组患者TTA启动时间、首次放射检查时间、急诊滞留时间,急诊至创伤手术室时间均短于对照组,差异均有统计学意义(P<0.05);观察组患者抢救成功率高于对照组,差异有统计学意义(P<0.05);观察组患者对急诊救治满意程度高于对照组,差异有统计学意义(P<0.05)。结论多学科合作一体化急救流程能有效提高急诊严重创伤患者的救治成功率,改善患者的预后,提高急诊救治满意度。
文摘为提高中医专业实习生处理急重症患者的能力,在西医外科创伤急救教学中,引进急救仿真模拟人(emergency care simulator,ECS),开展了模拟重症创伤患者真实情景的临床实习训练,与常规教学组进行了对照评价,并进行了问卷调查。结果显示,ECS培训组学生的理论考试和技能操作成绩均明显优于常规教学组(P<0.05),且学生对ECS教学给予了充分肯定和良好的评价,表明ECS训练教学可提高创伤急救的教学效果,有利于培养学生的临床判断能力和救治能力。
文摘【目的】研究无缝隙急救护理模式对急诊创伤患者抢救的影响。【方法】采用随机数字表法将2019年1月至2019年12月于本院就诊的150例严重创伤患者分为研究组与对照组,各75例,对照组给予常规急救护理,研究组给予无缝隙急救护理模式干预。统计两组各项急救时间、抢救成功率、急救不良反应事件以及救治7 d后患者Spitzer生存质量指数量表(Spitzer quality of life index,SQLI)评分。【结果】研究组患者确诊时间、急诊科停留时间、急诊到手术时间以及住院时间均明显少于对照组(P<0.05);研究组急救成功率明显高于对照组,研究组不良事件发生率明显低于对照组;研究组SQLI各项评分均高于对照组(P<0.05)。【结论】无缝隙急救护理模式应用于急诊创伤患者急救可明显缩短急救时间,降低不良事件发生率,提高急救效果。
文摘目的探讨院外创伤生命支持(prehospital trauma life support,PHTLS)课程在军队医院医护人员战创伤救治训练中的应用价值。方法选取2019年1—12月在解放军总医院第六医学中心参加PHTLS培训的医护人员为研究对象,分析培训前后考试成绩和心率、体温、收缩压3项生理指标变化,并采用问卷调查的方法分析培训前后问卷调查评分变化。结果参训人员78人,其中医生64人,占82.1%,护理人员14人,占17.9%,5年以上临床工作经验参训人员占70.5%,经理论和模拟病例考核有72人通过,通过率92%。培训考核结束后体温、心率和收缩压3项生理指标均不同程度的升高(P<0.01),问卷调查培训前平均评分(50.1±3.468)分,培训后及培训后半年平均评分为(66.2±2.46)、(64.2±1.835)分,均高于培训前(P<0.01)。结论PHTLS培训能增加医护人员创伤救治知识,提高救护技术水平,增强信心,增加团队配合经验,对于军队医院医护人员战创伤救治训练有一定价值。
文摘Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-thoracotomy benefits for patients with blunt traumatic hemothorax compared with conventional repair through full thoracotomy. Twenty-five patients underwent emergency operation for acute hemothorax from 2000. Five patients with less than 5% probability of survival (PS) were excluded, leaving 20 as the subjects. Results: Ten patients underwent conventional thoracotomy (conventional group) and the other 10 patients underwent VATS with mini-thoracotomy (VATS group). There was no difference between conventional group and VATS group in injury severity score (29.1 and 27.0) or PS (81.2% and 80.7%). Hospital mortality rates were 10% in conventional group and 0% in VATS group (N.S). Total amounts of intra-operative bleeding and post-operative transfusion until day 7 were 735 ml and 19.3 units in conventional group and 303 ml and 9.2 units in VATS group respectively (N.S). The length of ICU stay was 9.7 days in conventional group and 5.9 days in VATS group (N.S). Conclusion: VATS with mini-thoracotomy can be alternative for patients with blunt traumatic hemothorax in most emergency operations.
文摘Armed conflicts are increasing globally due to political unrest and the broader effects of climate change.Without resources to provide quality surgical care,it becomes nearly impossible to provide quality emergency surgery and trauma care similar to that in high-income countries.To understand and help aid organizations provide resources and address the surgical needs of populations facing armed conflict,a matrix to identify variables and help with interventions was envisioned.Apreviously published global surgery matrix based on the PIPES(Personnel,Infrastructure,Procedures,Equipment and Supplies)surgical capacity tool was adapted to this context.The novel matrix incorporates 108 variables.These variables are grossly divided into local and international agency components to address the issue of who is providing care.Using a time continuum of pre-conflict,conflict,and post-conflict allows organizations to concentrate on when during the conflict to target their intervention.In addition to the previously used personnel,infrastructure,procedures,equipment,and supplies categories,a sixth category called standards was included that addresses the issues such as information technology,data systems,quality improvement programs,and patient safety.Pilot testing of this matrix to obtain feedback from end users is the next step in development.Ultimately,peri-conflict preparedness should increase and improve surgical outcomes and reduce in death and disabilities around the world.
文摘The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.
