Impact of the coronavirus disease 2019 outbreak on the transportation of patients requiring emergency care.
Impact of the coronavirus disease 2019 outbreak on the transportation of patients requiring emergency care.
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DOI：
10.1097/md.0000000000023446
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发表时间：
2020-12-11
期刊：
影响因子：
1.6
通讯作者：
Seo YW
中科院分区：
文献类型：
--
作者：
Kim HS;Jang TC;Kim GM;Lee SH;Ko SH;Seo YW
韩国大邱广域市2019年首起确诊的冠状病毒病社区传播发生在2020年2月18日。在接下来的70天里，大约有6000个新病例发生，严重影响了医疗服务系统。本研究调查了危机对当地应急运输系统的影响。回顾性审查紧急医疗服务活动报告，以确定患者人口统计学和初始生命体征。根据患者的初始生命体征，对到达患者、将患者运送到医院和返回消防站的延迟进行评估和分类。研究期间分为4组（1/1-2/18、2/19-3/3、3/4-3/31和4/1-04/30），并分析组间差异。当与周期1相比时，请求参加现场和到达现场之间的时间差在周期2、3和4中分别延迟4分58秒、3分24秒和2分20秒;到达现场和到达医院之间的时间差分别延迟7分43秒、6分59秒和4分30秒;到达医院和返回消防局之间的时间差分别延迟29分3秒、25分55秒和18分44秒。 在第二阶段，与没有严重疾病症状的患者相比，要求到达现场与到达医院之间的时间差以及到达医院与返回消防局之间的时间差分别长6至23分钟和12至48分钟。 大多数延误影响发烧患者。在条件方面，转运时间延迟的统计效应量由大到小为：发热、缺氧、呼吸频率异常、呼吸系统症状和低血压。传染病的爆发导致紧急医疗运输系统的矛盾状态，导致严重病人的运输延误。因此，无论是传染病患者还是其他重症患者，都需要维持和改善医疗服务体系。
The first confirmed community transmission of coronavirus disease 2019 in Daegu Metropolitan City, South Korea, occurred on February 18, 2020. In the following 70-day period, approximately 6000 new cases occurred, severely impacting the medical service system. This study investigated the crisis-impact on the local emergency transport system. Emergency medical service activity reports were retrospectively reviewed to determine patient demographics and initial vital signs. Delay in reaching the patient, transporting the patient to the hospital, and returning to the fire station were assessed and categorized based on patients’ initial vital signs. The study period was divided into 4 groups (1/1–2/18, 2/19–3/3, 3/4–3/31, and 4/1–04/30) and intergroup differences were analyzed. When compared to Period 1, the time-difference between the request to attend a scene and arrival at the scene was delayed in Periods 2, 3, and 4 by 4 minute 58 s, 3 minute 24 seconds, and 2 minute 20 seconds, respectively; that between arriving at the scene and at the hospital was delayed by 7 minute 43 seconds, 6 minutes 59 seconds, and 4 minutes 30 seconds, respectively; and that between arriving at the hospital and returning to the fire station was delayed by 29 minute 3 second, 25 minute 55 second, and 18 minute 44 second, respectively. In Period 2, for patients with symptoms of severe illness when compared to patients lacking such symptoms, the time-difference between the request to attend the scene and arrival at a hospital and between arrival at the hospital and returning to the fire station were 6 to 23 minute and 12 to 48 minute longer, respectively. Most of the delays impacted patients with a fever. In terms of condition, the statistical effect size for delay in transport time was from large to small: fever, hypoxia, abnormal respiratory rate, respiratory symptom, and hypotension. Outbreaks of infectious disease cause a paradoxical state in emergency medical transport systems, inducing delays in the transport of severely ill patients. Therefore, maintenance and improvement of the medical service system for both patients with infectious disease and those with other severe illnesses is required.