报警系统策略在院前急救中缩短救护车响应时间的有效性

Siwakorn Chanchalotorn, Tin Ayurag, Supakorn Suwansilisil, Christsanutth Siripakkaphant, Petnumnueng Ponsumritchok, Nattaphan Siritikul, Supanut Waroonkun, Charupat Prayunsangrussamee, Parinya Tianwibool
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摘要

目的:救护车响应时间的缩短会增加患者的积极结果。因此,本研究的目的是确定在引入警报系统政策后,8分钟内完成的响应时间是否可以增加,并研究在引入警报制度政策后死亡率是否会降低。材料和方法:在以下日期之间对代码为红色的患者进行中断时间序列采集:2015年11月1日至2019年10月31日。数据来自清迈医院Maharaj Nakorn的医疗记录。收集的数据分为:方案前阶段(2015年11月1日至2017年10月31日)和方案后阶段(2017年11月31日至2019年10月30日)。结果:共有552名患者被纳入总体分析。红色代码患者在方案前和方案后8分钟内的反应时间成功率分别为64.62%和73.11%。研究发现,与方案前相比,方案后阶段的成功率显著更高(调整后的奇数比=1.627,95%置信区间:[1.017,2.602];p值<0.05)。从中断时间序列模型中观察到,在方案后阶段,24小时内的死亡率和急诊室(ER)的死亡率有所下降。然而,通过统计分析过程,没有明显的差异。结论:该方案的实施可显著缩短反应时间;从而实现了8分钟的目标。因此,该协议将能够在院前护理中促进更好的急救服务。
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Effectiveness of the Alarm System Policy on Reducing Ambulance Response Time in Prehospital Emergency Patient Care
Objective: Reduction of ambulance response time leads to an increase in positive patient outcomes. Therefore, the aim of this study was to determine whether an accomplished response time within eight minutes could be increased after the introduction of an alarm system policy and to study if the mortality rate would be decreased after the introduction of alarm system policy. Material and Methods: An interrupted time series was conducted in the collection of code red patients between the following dates: 1st November 2015 and 31st October 2019. The data was collected from the medical records of Maharaj Nakorn, Chiang Mai Hospital. The collected data were separated into: the pre-protocol period (1st November 2015 to 31st October 2017) and the post-protocol period (1st November 2017 to 31st October 2019). Results: A total of 552 patients were included in the overall analysis. The success rates of response time within eight minutes of patients with code red in the pre-protocol period and post-protocol period were 64.62% and 73.11%, respectively. It was discovered that the success rate was significantly higher (adjusted odd ratio=1.627, 95% confidence interval: [1.017, 2.602]; p-value<0.05) in the post-protocol period versus the pre-protocol period. A decrease in the mortality rate in 24 hours and the mortality rate in the emergency room (ER) was observed in post-protocol period, from the interrupted time series model. However, no significant difference was evident through the process of statistical analysis. Conclusion: The implementation of the protocol could significantly reduce response time; thus, achieving the 8-minute goal. Hence, this protocol will be able to promote better emergency services in pre-hospital-based care. 
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