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解答:首先要遵循时效性原则,和其它严重创伤急救一样,交通伤也是时间依赖性疾病,有救治的时间要求,应努力在伤后1小时内让伤员得到及时、有效的治疗,院内各个救治环节均要快速进行,迅速通过;其次是坚持一体化救治的原则,在严重创 相似文献
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论战创伤急救的时效性 总被引:22,自引:2,他引:20
目的 探讨战创伤急救的时效性对战创伤救治的指导意义。方法 围绕平、战创伤死亡统计资料分析战伤、平时创伤死亡与时间的关系;针对重点死亡高峰确定急救时间窗。结果 可控制的出血、解除窒息保持呼吸道通畅等应该在“急救白金10分钟”内完成;休克应该在30min内有效地干预并控制;胸、腹、盆腔的内脏损伤出血、严重的颅脑伤应该在“黄金1小时”内进行确定性的救命手术或控制损伤手术。结论 提高战创伤急救各阶段的时效性,要从群体急救知识的普及培训着手,改进军事卫勤理论和技术,才能有效降低战创伤伤员的伤残率与死亡率。 相似文献
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特种武器危重伤的特点与直升机救护 总被引:2,自引:0,他引:2
特种武器杀伤具有强度大,作用时间长,伤亡机制复杂,救治难度大等特点,传统的急救观念往往会丧失最宝贵的“救命黄金时间”。因此,我们建议,应确立现代急救的新概念,重视伤后1h,甚至伤后10min的最佳抢救时间,力争使伤员在最短的时间内得到确定性救治。 相似文献
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目的探讨批量伤员救治的接诊流程,以提高批量伤员的应急救治水平。方法 2009年7月~2012年3月我院急救中心接诊批量伤员共156人,通过启动绿色通道应急预案,快速分拣合安排至不同的救治区域,施行应对突发批量伤员处理预案,完善批量伤员的急救流程并运用于实践,共治愈149人,因病情危重,抢救无效死亡7人;抢救及时率达到100%。结果 156例中4例重型颅脑损伤患者到院后1~3h内死亡,3例多发伤致失血性休克到院30~60min内死亡,149例通过医院各科室的通力合作、全力抢救,均安然度过危险期治愈出院。结论绿色通道应急预案可以为救治重症伤员争取宝贵时间;在批量伤员的救治处理中起着至关重要的作用。因此,熟悉绿色通道流程,在实践中不断完善抢救流程可以显著提高批量伤员的急救效果。 相似文献
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急救绿色通道在严重创伤早期救治中的作用 总被引:3,自引:1,他引:2
目的 探讨绿色通道急救模式在严重创伤早期救治中的作用和意义. 方法 回顾性分析2006年1月-2007年11月以绿色通道急救模式救治60例创伤患者的效果,并与2004年1月-2005年12月收治的46例非绿色通道组患者的急救效果进行比较. 结果 两组患者性别、年龄、致伤机制、ISS及失血量等指标分布差异无统计学意义(P>0.05);绿色通道组60例患者死亡2例,死亡率为3%,对照组46例患者死亡5例,死亡率为11%(P<0.05).绿色通道组在急诊室处理时间、特殊检查时问、入院至手术室时间较对照组明显缩短(P<0.05). 结论 绿色通道急救模式缩短了严重创伤患者的救治空间和时间,显著降低了死亡率,提高了救治成功率,保证了创伤急救的"时效性和整体性". 相似文献
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1520例车祸所致严重创伤,其部位以骨折(39.1%)、复合伤(22.3%)、腹部伤(16.8%)最多,伴有休克者806例(53%),需紧急手术者1473例(96.9%)。死亡46例(3%),其中伤后1小时内死亡31例(67.4%)。我们采用CRASH—PLAN检诊计划检诊,最大限度避免漏诊,提高了抢救成功率。提出医护人员在抢救严重创伤时应有高度的紧迫感和责任感,最大限度地争取抢救时机,提高严重创伤的急救医疗效果。 相似文献
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在急救中心开展多发伤一体化救治分析 总被引:16,自引:5,他引:11
目的 探讨提高多发伤救治成功率的措施。方法 回顾性总结2002年6月~2003年6月间中山市急救中心开展多发伤救治的效果,分析多发伤一体化救治的模式和关键点。结果 共收治135例,抢救成功107例,成功率79.3%;死亡28例,死亡率20.7%。结论 (1)住急救中心实施多发伤一体化救治是提高其成功率的有效途径,也是多发伤救治的发展趋势,(2)在急救中心实施多发伤一体化救治的模式:急救中心设立创伤中心、建立成套的创伤急救体系,培养高素质专业人员.多发伤的诊治由急救中心医师实施或组织实施。(3)严重多发伤救治的关键点:抓好院前、院内急救——抢救生命;开展急诊手术——尽早修复损伤器官,消除致死致残因素;重视重症监护及治疗——进一步治疗原发损伤,保护各脏器功能,促进机体恢复,防止并发症。 相似文献
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In the past 20 years, emergency care concept has substantially changed on a cultural point of view, going well beyond the boundaries of medical science. It is now a general understanding that the real enemy of the critical patient is time; thus, functional organisation and collocation of human and technological resources in the emergency department (ED) can help avoid the loss of human lives. This "cultural revolution" led to the creation and development of structural and organisational models (layouts) of EDs. Now, emergency radiology has a central role in ED organisation, and the radiologist, providing 24-h coverage in the emergency room, is crucial for the correct diagnostic approach and rapid management of trauma. If this is the cultural background to the "emergency care" concept, an overview of such care in our country shows great differences from a structural, technological and organisational point of view. The presence of the radiologist providing 24-h coverage in the emergency room is still uncommon in many EDs The qualification of emergency care must be sought by studying the needs of the population and by seeking qualified personnel with high professional skill levels. All this must be understood and pursued by politicians and health care managers whose aim should be to coordinate and check the measures and human resources applied to the system. This process necessarily involves rewarding those health care professionals who prove to be up to the job. 相似文献
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Field evaluation and management of head and neck injuries 总被引:1,自引:0,他引:1
This article presents clear, concise guidelines for classification, evaluation, and emergency management of injuries that occur to the head and neck as a result of competitive and recreational sports. There are several principles that must be considered by individuals responsible for an athlete who sustains a serious head or neck injury: a person who "captains" the medical/first-aid team; knowledge of the appropriate emergency management techniques; availability of emergency medical equipment including a spine board, telephone, and ambulance; and a clear understanding of the philosophy that emergency management should "do no further harm." 相似文献
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Clinical/methodical issue
Diagnostic imaging of complex multiple trauma remains a challenge for any department providing modern emergency radiology (ER) service. An early and comprehensive approach for ER imaging is crucial for a priority-oriented and timely therapy concept with the aim of identifying potentially life-threatening injuries early and initiating appropriate treatment.Standard radiological methods
The basic diagnostic approach still consists of focused ultrasound using focused assessment with sonography for trauma (FAST) and conventional radiography (CR), usually limited to a single supine chest x-ray for triaging patients undergoing immediate operations.Methodical innovations
Multidetector computed tomography (MDCT) has become established as early whole body CT (WBCT) as the undisputable diagnostic method. The detection rate of injuries by WBCT is outstanding and it improves the probability of survival by 20–25?% compared with all other previous methods. At the same time, the spatial and temporal resolution of MDCT was improved resulting in considerably shortened examination times but WBCT is still associated with a significant radiation exposure, even in the acute single use setting. Using modern scanner and dose reduction technology, including iterative reconstruction, a dose reduction of up to 40?% could be achieved. The substantial number of images in WBCT is another challenge; images must be processed priority-oriented, read and transferred to the picture archiving and communications system (PACS). For rapid diagnosis, volume image reading (VIR) offers additional options to keep the diagnostic process on time.Achievements/practical recommendations
Modern WBCT after multiple trauma is performed early, comprehensively and personalized so that WBCT improves the probability of survival by 20–25?%. 相似文献18.
Radiological emergency management of multiple trauma patients 总被引:1,自引:0,他引:1
In recent years there has been major improvement in the management of patients with serious injuries. The initial imaging
technique for multiple trauma patients is also undergoing change. In addition, other innovations including specialisation
in training (casualty surgery), preclinical services (emergency medical care/ambulance system), optimisation of early clinical
procedures (guidelines for action) and modification of clinical treatment strategies (conservative/operative/interventional)
have altered the management of these patients. Conventional X-ray diagnosis, which has played a major role to date, is now
increasingly giving way to modern cross-sectional imaging, in particular CT. This tendency has been seen in Germany particularly
since the introduction of spiral CT. However, to minimise any risk to critically injured patients, standards must be defined
with regard to physical structure, emergency room equipment and quality. The basic principles, the current situation and suggestions
for improvement with regard to the emergency management of multiple trauma patients are put forward and discussed from the
radiologic point of view. 相似文献
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目的回顾分析2010年上海世博会期间世博园区相关的医疗转运服务中创伤患者的急救及转运情况,为今后此类大型公共活动中创伤患者的院前救治及急救转运提供参考。方法收集此次世博会期间上海市医疗急救中心记录的全部世博相关随车病例,通过对接受转运的创伤患者的性别比例、创伤部位、创伤原因、现场处置方法及转运耗时情况等指标的分析,研究这部分创伤患者的基本情况、疾病特点、现场救治及转运情况等相关信息。结果因创伤需转运患者的平均年龄为42.88岁,以女性患者居多。最常见的创伤部位为四肢(62.17%)及头面部(27.82%)。园区内转运创伤患者的平均耗时为9.10min,园区与定点医院间转运创伤患者的平均耗时为15.23min。创伤患者现场急救和随车急救的各项措施实施率均<20%。结论上海世博会与各类大型公共活动一样,创伤是发病率最高的疾病类型。正确评估创伤种类及伤情,分析受伤群体特点,科学合理的医疗保障配置,规范的现场急救和及时的转运是创伤患者得到良好救治的基本保证。其次,进一步完善大型公共活动医疗数据的统计、汇总工作,取得更多完整的客观数据,以便制定出大型公共活动医疗保障规范。 相似文献
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颅脑损伤合并多发伤是医院急诊较难处理的问题之一,常影响患者的预后。本文就颅脑损伤合并多发伤急诊救治模式进行初步探讨,对其院前急诊和院内抢救的模式、人员配备模式以及相关的抢救原则进行了阐述,以期进一步规范创伤外科医师对颅脑损伤合并全身多发伤急诊救治策略,提高救治水平。 相似文献