急救医学新模式新技术的研究与影视录像制作

目的 探索急救医疗服务体系建设及运行的有效模式,创作急救医学影视教材,提高急救医疗质量和水平.方法 (1)对国内外急救医疗体系的建设与发展进行调研、分析,总结特点,积累资料;(2)充分利用有效资源,创建急救医学运行模式;(3)制作现代急救医学影视教材;(4)运用实践.结果 按新模式运行后各急救医疗指标均明显提高.结论 该项目成果能规范急救医疗服务行为,提高急救效能,提高对危重患者救治和对突发公共卫生事件及灾害事故的应对能力和水平,具有可推广性.     

新型考核评价体系在急诊医学教学中的构建与实践

急救医学虽然只是医学的一个分科,但包涵极其丰富的内容,涉及生活意外急救、野外急救、灾难急救、战场急救等领域.急救医学是研究为挽救人们的肢体、器官、脏器功能甚至生命的紧急救援措施发展的学科[1].从业人员必须具有高度的责任感,丰富的医学知识及技能,理论与实践融会贯通的能力,综合分析、运用其他医学分科知识的能力[2].     

院前急救护理中常见的隐患及对策

随着社会的发展,人们对院前急救的意识越来越强.新的急救医学模式已把院前急救、院内急救、急诊ICU紧密联系在一起."120"急救电话的开通满足了人民的需求.院前急救是指伤病员进入医院以前的医疗急救,是急诊医疗体系的首要环节和重要的基础,是急救医学发展的先决条件.包括对伤病员的现场抢救、途中监护和安全转运[1] .由于院前急救的特点和三大要素,要求护士必须具备良好的素质,具有扎实的基本功.认真执行交接班制度,认真检查急救器材、急救药品和物品,定期组织院前急救知识、技能的学习与培训,定期实施急救技能的演练,以优质、高效的院前急救水平最大限度地减少和杜绝医疗纠纷与事故的发生.     

谈急诊护理常规

随着社会的不断发展和进步,人类各种疾病和灾难的发生也越来越多,急救医学涵盖的内容越来越广,急救医学也承载着越来越重的任务和责任. 急救医学包括院前急救、院内急救两大部分,目前院前急救主要以120急救系统为主,而院内急救则以各个医院急诊科为主,有的地区急救120与当地医院急诊科结合起来成为一体.     

急诊护理常规

随着社会的不断发展和进步,人类各种疾病和灾难的发生也越来越多,急救医学涵盖的内容越来越广,急救医学也承载着越来越重的任务和责任. 急救医学包括院前急救、院内急求两大部分,目前院前急救主要以120急救系统为主,而院内急救则以各个医院急诊科为主,有的地区急救120与当地医院诊科结合起来成为一体.     

医院急诊急救管理综述

社会不断发展,医学水平不断提高,使得医院急诊急救受到大家的广泛关注.急诊急救几乎涉及医学各个领域,因此,急诊急救管理的质量直接关系到患者的生命安全.改善医院急诊急救管理现状,在很大程度上可以有效促进医学事业的发展,意义重大.本次研究对医院急诊急救管理现状进行了解和分析,以便改善医院急诊急救效果,提高医疗服务水平.     

病案库在急诊医学临床教学中的建立及应用

急诊医学是一门具有急救新理论、新技术涉及各科领域的跨专业学科.根据其自身的特点和发展,建立急诊医学病案库是必要的.正确应用急诊医学病案能提高急诊医学临床实践教学质量,为医学生进入急诊临床工作奠定良好基础.     

中医院校急救医学培养模式的建设

为探讨建立中医院校中西医结合急救医学培养模式的意义，介绍中西医急救医学培养模式的基本建设情况。结果证明中西医急救医学培养模式的建立，有助于医学生综合运用中西医急救知识和实践技能，进行辩证施治，有助于探索出具有中国特色的中西医结合急救医学培养模式，有助于培养高素质中西医结合急救医学专业人才。     

《急诊医学》教学对提高本科生思维方法和专业技能的影响

①目的 通过在大学开设《急诊医学》选修课,探讨对提高学生临床综合思维能力和实际操作能力、急救知识的影响.②方法 采用写心得体会、问卷调查和急救技能考核,对403名大学生进行调查并计分,统计学处理用SPSS10进行.③结果 大学生急诊急救基本常识和实际操作能力知识平均得分（65.98±14.34）分,选修《急诊医学》者与未选修该课程者得分有明显差异.④结论 在医学院校本科开设《急诊医学》必修课程,能提高医学本科生的综合分析、判断思维能力及实践操作技能和急救知识.     

基于网络的急救医学教学方法改革

融教学、科研与临床工作为一体的急救医学网站建设是急救医学课堂教学的有效延伸和拓展,培养了学生自主学习、创新学习和终身学习的能力,在提高急救医学教学质量和急救医学人才培养上发挥了重要的作用。     

重症医学的教学现状与思考

重症医学教学面临“综合重症”还是“专科重症”、课程设置方式、团队工作能力培训、教学平台搭建和师资队伍等诸多挑战性问题。重症医学教学需要在学科整体观的指导下,以“重症医学亚专科建设”为契机,兼顾“综合重症”和“专科重症”,合理规划《重症医学》课程,做好ICU建设与整合,打造重症医学临床实践综合平台,开展临床实践与团队工作能力培训。同时,立足专业特色,建设优质的重症医学师资队伍。     

重症医学发展现状及研究热点

危重症医学是为急性、危及生命的危重病人提供生命支持和医疗照顾的学科.危重症医学的出现和发展对临床医学产生了重大影响.危重症医学领域包含着大量和广泛的科学知识,重症医学的发展在体现和提高综合医疗水平方面取得了令人瞩目的成就,同时也面临着严峻的挑战.我们要充分发挥已有的优势,建设一支具有多学科知识和经验基础的医疗团队,进一步提供更高质量的医疗服务和不断促进危重症医学的发展,以造福于人类的健康事业.     

危重症医学教学探讨

危重症医学是通过充分而合理运用先进的医学理论与技术为危重病人提供有效生命支持和医疗照顾从而提高病人生存率的学科。医学生应掌握救治危重病人的基本技术。虽然危重症医学教育非常重要,但我国目前还没有正规的危重症医学培训教材和课程以供医学生学习和掌握临床抢救的基本技能。本文从临床教学现状和需求出发,探讨适合我国医学生危重症医学教育的策略。     

危重症医学——快速发展的临床学科

危重症医学是为急性、危及生命的危重病人提供生命支持和医疗照顾的学科。近10年来,危重症医学在世界范围内的快速发展,对临床医学产生了重大影响。今天的危重症医学领域包含着大量和广泛的科学知识,同时也面临着严峻的挑战。需要一支有着多学科知识和经验基础的医疗团队进一步提供最高质量的医疗服务。     

重症超声核心技术与可视化诊疗核心技能

重症超声是将床旁超声技术进行临床化、重症特色化的应用。重症超声具有多重角色作用,既可以作为一种无创监测工具获取反映病情的数据指标,又能作为一种全面可视化的评估手段监测脏器病理生理状态及结构改变,助力重症专业医师全面、深入地掌握病情,高效、准确地丰富其临床决策依据,提高诊治的精准性和高效性。因此,业界已将重症超声作为重症救治的核心技术之一。重症超声的特点和优势决定了其是天然的可视化诊疗载体,所以我们一直致力于探索将重症超声的应用动态地融入具体的临床诊治项目中,建立相应的应用流程,用以规范临床医师的诊治行为,减少医疗差错。由此产生了一种新的诊疗方式,即以重症超声可视化证据为支撑,以病理生理状态为导向的流程化规范诊疗——重症超声可视化诊疗。本文从重症超声的形成与内涵、重症超声作为核心技术的应用方式、重症超声可视化诊疗的价值及重症救治中必需使用重症超声的环节等几方面展开论述和梳理,以期后继更好地开展科研和临床实践,拓展重症超声的价值,助力重症医学的发展。     

从卫气营血辨证辨析全身炎症反应综合征

SIRS是目前基础医学和临床急救/危重病医学研究的重点。临床治疗中尽管全力采取积极复苏、器官支持、抗感染、介质拮抗等手段,SIRS/MODS病死率仍居高不下。文章从全身炎症反应综合征（SIRS）的临床传变过程、血清学指标及脏腑传变规律与中医学＂卫气营血辨证＂体系的相关性出发,为SIRS建立一个合理的中医学辨证体系进行探讨。     

Identifying variations in quality of care in Queensland hospitals

Identifying and acting on variations from good practice is one of the critical tasks of clinical governance. We describe one aspect of Queensland's post-Bundaberg clinical governance arrangements: the use of variable life-adjusted displays (VLADs) to monitor outcomes of care in the 87 largest public and private hospitals in Queensland, which together account for 83% of all hospital activity. VLAD control charts were created for 31 clinical indicators using routinely collected data, and are disseminated monthly. About a third of hospitals had a run of cases in the 3-year period that flagged at the 30% level (local level investigation). For three indicators, about one in five hospitals had sufficiently cumulatively more deaths than statistically expected that the hospital was highlighted for state-wide review. VLADs do not provide definitive answers about the quality of care. They are used to develop ideas about why variations in reported outcomes occur and suggest possible solutions, be they ways of improving data quality, improving casemix adjustment, or implementing system changes to improve quality of care. Critical to the approach is that there is not just monitoring - the monitoring is tied in with systems that ensure that investigation, learning and action occur as a result of a flag.     

重症医学教学思考

重症医学是一门研究危重疾病发生、发展规律及其诊治方法 的新兴学科.本文从重症医学教学现状和社会需求出发,阐述了临床医学专业设置本门课程的必要性,并就如何加强教师队伍建设和改进教学方法 进行了探讨.     

Career choice of 'fifth pathway' graduates from New York state medical schools

Graduates of "fifth pathway" programs at medical schools in New York state between 1976 and 1978 were studied to determine their professional careers and choice of medical specialties. Of the 545 physicians participating in the program, 510 were able to be located. Of this latter cohort, 177 (34.7 percent) had entered primary care fields as of 1981. Of the physicians no longer in residency training, 19.1 percent had full-time salaried positions in academic institutions, and the remaining physicians were engaged in various clinical medical activities. Of the 545 fifth pathway graduates, 74 (13.6 percent) had not been able to pass the licensing examinations as of 1981, and an additional 54 (9.9 percent) had not taken those examinations. Comparisons with regular students graduating from a medical school in New York state showed that fifth pathway graduates were more likely to select nonprimary care specialties than primary care specialties (p less than 0.001). These data suggest that although a majority of graduates of fifth pathway programs in New York state are involved in the provision of health care, a small number are still unable to engage in the practice of medicine.     

Medical home care services for the housebound elderly.

In our health jurisdiction the proportion of elderly people is more than double the national average, and there is a severe shortage of both home care services and long-term care beds. To help the many elderly housebound people without primary medical care we initiated a medical services home care program. The goals were patient identification, clinical assessment, medical and social stabilization, matching of the housebound patient with a nearby family physician willing and able to provide home care and provision of a backup service to the physician for consultation and help in arranging admission to hospital if necessary. In the program's first 2 years 105 patients were enrolled; the average age was 78.9 years. More than 50% were widowed, single, separated or divorced, over 25% lived alone, and more than 40% had no children living in the city. In almost one-third of the cases there had never been a primary care physician, and in another third the physician refused to do home visits. Before becoming housebound 15% had been seeing only specialists. Each patient had an average of 3.2 active medical problems and was functionally quite dependent. Thirty-five of the patients were surveyed after 1 year: 24 (69%) were still at home, and only 1 (3%) was in a long-term care institution; 83% were satisfied with the care provided, and 79% felt secure that their health needs were being met. One-third of the patients or their families said that it was not easy to reach the physician when necessary. We recommend that programs similar to ours be set up in health jurisdictions with a high proportion of elderly people. To recruit and retain cooperative physicians hospital geriatric services must be willing to provide educational, consultative and administrative support.