The profile of patients attending a triaged eye emergency service

Background

Galway University Hospital provides a 24-h referral eye emergency service for patients triaged by a primary health network.

Aims

A prospective study was designed to evaluate the profile of patients referred to the eye emergency service and an attempt was made to compare the data recorded to those of a walk-in eye casualty.

Methods

All cases seen in Galway University Hospital eye emergency service over five consecutive weeks in 2012 were recorded and analyzed.

Results

Four hundred and eight cases were seen in total. 312 (76.5 %) were seen during normal working hours and 96 (23.5 %) after-hours. 33.3 % of cases were inflammatory and 31.9 % traumatic. Anterior uveitis [39 cases (9.6 %)] and corneal abrasion [37 cases (9.1 %)] were the most common diagnosis, while bacterial keratitis [9 cases (2.2 %)] and globe rupture/penetration [4 cases (1 %)] were the most serious. 85.6 % of patients were seen within 30 h from referral. A&E department was the main referral source (35 % of cases seen during normal hours and 70.8 % of those seen after-hours). 42.5 % of patients needed to be followed-up in the clinics. Seventy-two patients (17.6 %) were seen after 5 pm, Monday to Monday. Twenty-one were traumatic, 4 required admission and only 9 were deemed inappropriate after assessment.

Conclusions

Serious eye pathology presents after normal working hours. The triage process results in lower number of minor complaints being referred to the service. Compared to a walk-in casualty, a triaged service manages greater percentage of complex pathology.     

急诊科分组排班的成效

目的 探讨护理人员分组排班在急诊科实际应用的成效.方法 将护理人员分为院前急救组、急诊抢救组、急诊留观组、门诊急诊输液组4个小组分开排班,每个小组设一名小组长协助护士长管理.结果 实行两年多分组排班使护理质量明显提高,每个小组都有所作为,获得医生、患者和护理部的好评.结论 通过分组排班,调动了护士的积极性,在科内形成良好的学习气氛,提高了护士专业水平和临床工作质量,密切了医护关系.     

The impact of a rotorcraft aeromedical emergency care service on trauma mortality

The mortality of 150 consecutive trauma patients treated at the site of injury and transported to a trauma center by standard land prehospital care services was compared with that of 150 consecutive trauma patients treated at the site of injury and transported to the same trauma center by a rotorcraft aeromedical service staffed by a physician and nurse. A statistical analysis designed to predict mortality based on injury severity revealed that the mortality of the land group was statistically no different from that of a large index trauma patient population treated at a major trauma center. There was a 52% reduction in predicted mortality of the aeromedical group, which was highly significant.     

互联网络在急诊医疗救助中的运用

从互联网络在急诊医疗救护中的运用情况,互联网络在急诊医疗救护中的运用构想,网络的多元化技术在急诊救助中的运用进行综述,为进一步研究提供参考.     

32例精神科重症患者肠内营养支持治疗的临床研究

目的:探讨序贯性肠内营养支持治疗在精神科重症患者应用的有效性。方法:将67例精神科重症患者按入院顺序分为两组,研究组32例和对照组35例。两组患者营养治疗第1 d和治疗20 d后,分别进行营养指标的比较,观察其并发症的发生率和药物不良反应的程度。结果:经20 d治疗后研究组患者营养指标好于对照组,且并发症发生率低,药物不良反应轻,两组比较差异有统计学意义(P<0.05或P<0.01)。结论:精神科重症患者急性期,早期应用序贯性肠内营养支持治疗方式,可以改善患者机体的营养状况,减少并发症的发生,减轻药物不良反应,有利于患者的早期康复。     

精神科急诊患者的自杀危险因素分析

目的 旨在评估精神科急诊患者自杀的临床、心理、社会学和生物学危险因素。方法 对首都医科大学附属北京安定医院2015至2017年精神科急诊就诊患者进行横断面分析,采用自杀危险因素评估表对患者进行自杀想法和行为(suicidal thoughts and behaviors,STB)检测,得分≤10分和>10分分别表示STB的存在和不存在,多因素Logistic回归分析确定STB的危险因素。结果 共纳入12 345例患者,其中女性6 885例(56%)。患者年龄36(27～50)岁,简明精神病评定量表(Brief Psychiatric Rating Scale,BPRS)总分、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)总分、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)总分、杨氏躁狂量表(Yung Manic Rating Scale,YMRS)总分平均分分别为32(27～39)分、7(3～13)分、10(6～15)分和7(4～18)分。根据自杀风险评估表,有3 436例(27.83%)患者有STB的危险。多因素分析显示,居住地、性别、婚姻状况、同住者、受教育年限、职业状况、与父母和兄弟姐妹的关系、诱因、性格、确定诊断、躯体疾病、简明精神疾病总分、焦虑总分、抑郁总分、躁狂总分、就医时间、精神科住院总次数是STB的独立危险因素。结论 精神科急诊患者自杀风险较高,以中青年为主,尤其以男性、未婚、失业、社会和家庭支持较差的精神疾病患者为著。STB在这一人群中受到生理、心理和社会因素的影响。