瑞典救护车服务中的小儿创伤患者 - 评估、干预和临床结果的回顾性观察研究

Glenn Larsson, Sanna Larsson, Viktoria Strand, Carl Magnusson, Magnus Andersson Hagiwara
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引用次数: 0

摘要

在瑞典急救医疗服务机构(EMS)收治的外伤患者中,儿童外伤患者占了很大一部分,而且外伤仍然是瑞典儿童死亡的一个重要原因。先前的研究已经发现了院前评估和干预儿科患者可能面临的挑战。在瑞典,有关急救医疗服务中儿科创伤患者的信息非常有限。本研究旨在调查瑞典急救服务中儿科创伤患者的发病率,并描述院前评估、干预措施和临床结果。这项回顾性观察研究在瑞典西南部的一个地区进行。研究人员从2019年的救护车和医院记录中随机抽样。纳入标准为0-16岁的儿童,这些儿童涉及创伤并接受过急救中心临床医生的评估。共有 440 名儿童被纳入研究,占创伤病例总数的 8.4%。中位年龄为 9 岁(IQR 3-12),60.5% 为男性。受伤的主要原因是低能量(34.8%)和高能量跌落(21%),其次是交通事故。4.5%的儿童被评估为严重受伤。四分之一的儿童在评估后仍留在现场。29.3%的儿童接受了完整的生命体征评估,81.8%的儿童按照ABCDE结构进行了评估。院前专业人员最常采取的干预措施是给药。死亡率为 0.2%。小儿外伤病例占外伤总人数的 8.4%,受伤机制和类型各不相同。相当一部分儿童的生命体征评估不完整。不过,对 ABCDE 结构的遵守程度较高。为了患者的安全,需要对评估后仍留在现场的儿童进行进一步调查。
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Pediatric trauma patients in Swedish ambulance services -a retrospective observational study of assessments, interventions, and clinical outcomes
Pediatric trauma patients constitute a significant portion of the trauma population treated by Swedish Emergency Medical Services (EMS), and trauma remains a notable cause of death among Swedish children. Previous research has identified potential challenges in prehospital assessments and interventions for pediatric patients. In Sweden, there is limited information available regarding pediatric trauma patients in the EMS. The aim of this study was to investigate the prevalence of pediatric trauma patients within the Swedish EMS and describe the prehospital assessments, interventions, and clinical outcomes. This retrospective observational study was conducted in a region of Southwestern Sweden. A random sample from ambulance and hospital records from the year 2019 was selected. Inclusion criteria were children aged 0–16 years who were involved in trauma and assessed by EMS clinicians. A total of 440 children were included in the study, representing 8.4% of the overall trauma cases. The median age was 9 years (IQR 3–12), and 60.5% were male. The leading causes of injury were low (34.8%) and high energy falls (21%), followed by traffic accidents. The children were assessed as severely injured in 4.5% of cases. A quarter of the children remained at the scene after assessment. Complete vital signs were assessed in 29.3% of children, and 81.8% of children were assessed according to the ABCDE structure. The most common intervention performed by prehospital professionals was the administration of medication. The mortality rate was 0.2%. Pediatric trauma cases accounted for 8.4% of the overall trauma population with a variations in injury mechanisms and types. Vital sign assessments were incomplete for a significant proportion of children. The adherence to the ABCDE structure, however, was higher. The children remained at the scene after assessment requires further investigation for patient safety.
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