基层医院如何规范院外急救程序的探讨

目的探讨基层医院如何规范院外急救程序及其对急救救治效果的影响。方法通过比较和分析执行急救程序前后急救组与对照组间救治效果，主要统计心肺复苏成功率，现场处置率包括现场徒手心肺复苏操作率，院外复苏现场气管捕管率，现场电击除颤率，现场复苏药物注射率，现场四项外科急救技术使用率等指标。结果院内反应时间急救组较对照组明显缩短（P〈0．01）；徒手心肺复苏操作考核，培训前后得分差异具有统计学意义（P〈0．05）；心肺复苏质量明显提高。现场处置率、心肺复苏成功率急救组较对照组明显提高（P〈0．05）。结论执行规范的院外急救程序后，患者的院外救治效果有明显的提高，基层医院应该具备规范化、专业化的院外急救程序。

Primary pre-hospital emergency care procedures

Objective To study how to standardize the first-aid program in primary pre-hospital emergency medical care and how to improve first-aid effect. Methods A retrospective analysis of 2049 cases was performed between 2005 and 2009 in Zhaoqing City Second People＇ s Hospital. All cases were divided into two groups. Control group which included 996 cases between January 2005 and January 2006 who cared before the training program established. Emergency group included 1053 cases between January 2008 and April 2009 who were in charge with trained pre-hospital medical professional. We compared and analyzed the first-aid effect between the two groups, major target including the success rate of cardiac pulmonary resuscitation （CPR）, the rate of on site manage including the rate of on-site CPR, the rate of pre-hospital tracheal intubation, the rate of on-site defibrillation, the rate of on-site intravenous injection, the rate of utilization of the four kinds of surgical technology. Results As compared with control group, the reaction time was shorter （P〈0.01）; the score of CPR examination was higher in the emergency group （P〈0.05）. There was a significant difference in the success rate of CPR between two groups （P〈0.05）. Conclusion Primary hospital must have standard and special first-aid program. It was very important and effective emergency medical care to carry out the standard first-aid program in pre-hospital.