Hospital and emergency ambulance link: using IT to enhance emergency pre-hospital care
Hospital and emergency ambulance link: using IT to enhance emergency pre-hospital care
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DOI：
10.1016/s1386-5056(01)00137-x
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发表时间：
2001-05-01
影响因子：
4.9
通讯作者：
Han, LS
中科院分区：
文献类型：
--
作者：
Anantharaman, V;Han, LS
传统上，急救车只在上下班的情况下通知接收医院病人即将到达，这种情况平均占救护车运行的5%以下。信息传递通常是稀疏的。对于所有其他运行，仅在到达急诊室（艾德）时提供信息。在新加坡，一个综合的电子救护车病例记录作为一个试点项目在三辆紧急救护车和那里最繁忙的艾德之间创建。救护车工作人员捕获的所有信息，包括生命体征信息和心电图，都被输入或下载到救护车上一台简陋的PC上，然后将完整的救护车记录传输到急诊室。通过公共移动的数据网络进行无线传输。对这一试点运行进行的3个月分析显示了以下情况。(1)通过电子方式获取一份完整的救护车病例记录的平均时间为93 s，而传统的书面记录为7分7 s。(2)数据的空中传输时间约为4秒，除非ECG波形也被传输，导致传输时间经常超过60秒。(3)在75%的医院和紧急救护车链接（HEAL）救护车中，至少有68%的数据可以传输，而在不到5%的非HEAL救护车中，只有25%的数据可以传输。(4)由于HEAL，护理人员在艾德的时间从15分钟减少到8分钟。(5)重症监护患者在艾德急诊室的等待时间从35分钟减少到17分钟，如果由HEAL救护车带来。(6)HEAL系统能够在接近100%的情况下有效地提示护理人员进行治疗的关键方面。(7)试验性的HEAL系统只可对救护车的特定运作进行有限度的自动审核。在证实HEAL系统的可行性后，我们迟早会加强系统的功能，例如在病人现场收集电子资料、以声音输入资料、从现场传送资料，自动救护车审计和提高救护车的专业护理水平已成为普遍的现实。(C)2001爱思唯尔科学爱尔兰有限公司保留所有权利。
Emergency ambulances traditionally inform receiving hospitals of impending arrival of patients only in instances of load and go situations, which on average constitute less than 5% of ambulance runs. Information transmitted is usually sparse. For all other runs, information is made available only on arrival at the emergency department (ED). There have also been numerous limitations associated with voice transmissions.A comprehensive electronic ambulance case record was created as a pilot project in Singapore between three emergency ambulances and the busiest ED there. All information captured by the ambulance crew, including vital signs information and ECGs was entered or downloaded onto a ruggardised PC in the ambulance and this complete ambulance record was transmitted to the ED. Transmission was wireless via the public mobile data network. A 3-month analysis of this pilot run revealed the following.(1) It was possible to capture a complete ambulance case record electronically at a mean time of 93 s vs 7 min 7 s for the traditional written record. (2) Air transmission time for data was approximate to4 s unless ECG wave forms were also transmitted resulting in transmission times frequently exceeding 60 s.(3) At least 68% of data was transmissible in 75% of Hospital & Emergency Ambulance Link (HEAL) ambulances as opposed to only 25% in less than 5% Of non-HEAL ambulances.(4) Paramedics' time in the ED decreased from 15 to 8 min as a result of HEAL.(5) The waiting time for critical care patients to be seen at the ED decreased from 35 to 17 min if brought by HEAL ambulances.(6) The HEAL system was able to effectively prompt paramedics in carrying out critical aspects of treatment in close to 100% of instances.(7) The pilot HEAL system was able to demonstrate a limited amount of automated audit of specific aspects of ambulance runs.Having demonstrated the feasibility of the HEAL system, it is a matter of time before enhanced features such as electronic data collection at patient site, voice activated data entry, transmission of data from site, automated ambulance audits and an enhanced level of professional care in the ambulances become common-place reality. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.