急诊科引发医疗纠纷的猝死分析

目的探讨在急诊科引发医疗纠纷的猝死患者的特点,提高早期识别高危人群,降低猝死率的能力,减少医疗纠纷。提高对危急重症患者的救治水平。方法对3年来深圳市人民医院龙华分院急诊科17例猝死患者分析,其中8例引发过较大医疗纠纷,3例有尸检报告,5例依靠临床推断。对其临床经过、直接死因、医疗过失及家属行为等进行分析。结果直接死因中3例为主动脉夹层破裂,3例为心肌梗塞,1例甲亢危象,1例高血压脑溢血。结论急诊科猝死患者发病急骤、死亡迅速,家属从感情上难以接受;部分病例发病不典型,或缺乏既往发病史,临床医师缺乏经验导致误诊与漏诊,这两方面的原因都增加了纠纷发生的可能性。

Medical Disputes Caused by Sudden Death in Emergency Department

Objective To identify characteristics of sudden death patients involved in medical disputes in emergency department.Methods Seventeen cases were analyzed,of which 8 cases were major: 3 cases identified by autopsy reports and 5 by clinical inferences;aspects like clinical courses,direct causes of death,malpractices as well as families’ behaviors were discussed.Results Of the 8 cases,3 caused by dissection of aorta rupture,3 of heart infarction,1of hyperthyroidism crisis and 1 of cerebral hemorrhage.Conclusion Families are hard to accept emotionally;medical disputes increase due to following reasons: shortage of experiences in clinicians,atypical onset and lacking of prevision medical history.