[重新评估交通事故后紧急医疗服务部署指示目录]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-05-01 Epub Date: 2024-02-02 DOI:10.1007/s00113-023-01408-8
Michael Hetz, Stefan Babisch, Thomas Unger, Klaus-Dieter Schaser, Christian Kleber
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引用次数: 0

摘要

背景:急诊医生指示目录基于过时的研究,为交通事故后的报警标准提供了有限的指导。由于车辆安全技术的进步和可用资源的变化,有必要对适应症进行重新评估。这项回顾性登记研究旨在确定交通事故中严重受伤的临床前可评估变量:方法:纳入 GIDAS 数据库中 2000 年 1 月 1 日至 2021 年 12 月 31 日期间发生事故的 47,145 人。对重伤(AIS 3+)和轻伤的不同数据集进行了评估:结果:弹射(PPV 80.6%)、被困(PPV 75.6%)、车辆燃烧(PPV 57.1%)、救援困难(PPV 56.3%)、车辆解体(PPV 51.6%)和失忆(PPV 50.3%)表明车内人员受伤严重。对于易受伤害的道路使用者(摩托车手、自行车手、行人),头盔丢失(PPV 61.1%)、被碾压/拖拽(PPV 41.9%)、对方车窗破裂(PPV 35.8%)和随后与物体碰撞(PPV 31.1%)也被确定。χ2检验显示,这些变量与严重受伤之间存在显著关联。综合变量的 PPV 值超过 82%:讨论:目前的急诊医生适应症目录提供的临床前检测标准有限,应根据客观登记数据进行修订。应测试急诊调度员的查询模型。
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[Reassessment of the emergency medical service deployment indication catalogue after traffic accidents].

Background: The emergency physician indication catalogue is based on outdated studies and provides limited guidance for alarm criteria following traffic accidents. Advances in vehicle safety technology and changes in available resources necessitate a re-evaluation of the indications. The aim of this retrospective registry study is to identify preclinically assessable variables for severe injuries sustained in traffic accidents.

Methods: A total of 47,145 individuals involved in accidents between 1 January 2000 and 31 December 2021 from the GIDAS database were included. Separate datasets for severe (AIS 3+) and minor injuries were evaluated.

Results: Ejection (PPV 80.6%), entrapment (PPV 75.6%), burning vehicles (PPV 57.1%), challenging rescue situations (PPV 56.3%), vehicle disintegration (PPV 51.6%), and amnesia (PPV 50.3%) indicated severe injuries among vehicle occupants. For vulnerable road users (motorcyclists, cyclists, pedestrians), helmet loss (PPV 61.1%), being run over/dragging (PPV 41.9%), opponent vehicle window breakage (PPV 35.8%), and subsequent collision with objects (PPV 31.1%) were also identified. The χ2-test revealed significant associations between the variables and severe injuries. Combined variables achieved PPV values above 82%.

Discussion: The current emergency physician indication catalogue provides limited preclinically detectable criteria and should be revised based on the objective registry data. Query models for emergency dispatchers should be tested.

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