Objective: To understand the current situation of prehospital first aid knowledge, attitude and behavior of university students in Jingzhou City. Methods: A prehospital first aid knowledge questionnaire and the conven...Objective: To understand the current situation of prehospital first aid knowledge, attitude and behavior of university students in Jingzhou City. Methods: A prehospital first aid knowledge questionnaire and the convenience sampling method were used to survey 307 university students in Jingzhou City. Results: The mean score of prehospital first aid knowledge of university students in Jingzhou City was 12.85 ± 2.643, the mean score of attitude was 50.73 ± 4.114, and the mean score of behavior was 39.05 ± 8.898;There was a statistically significant difference in the scores of prehospital first aid knowledge, attitude, and behavior of university students depending on whether or not they had received prehospital first aid training (P P Conclusion: Jingzhou University students have a positive attitude toward pre-hospital first aid, but the knowledge level and behavior are low, which suggests that the government, society and the school should create good conditions to promote the improvement of pre-hospital first aid knowledge and ability.展开更多
Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI). Methods A total of 807 consecutive patients with AMI who presented to the emergency department...Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI). Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.展开更多
BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for preho...BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.展开更多
To the Editor：Airway management is a crucial skill for emergency physician, who＇s often called to deal with difficult airways and requests for quick, simple and effective responses, as the many factors responsible f...To the Editor：Airway management is a crucial skill for emergency physician, who＇s often called to deal with difficult airways and requests for quick, simple and effective responses, as the many factors responsible for difficulties might be enhanced by emergency setting.[1] We now have many rescue devices as the LMA, I-gel, but they do not provide a definitive airway, and recent studies evaluating the use of the videolaryngoscopes in emergency show conflicting results.展开更多
Objective:to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury(TBI).Methods:medical staff were trained about the ...Objective:to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury(TBI).Methods:medical staff were trained about the prehospital first aid for 2 months to fully master the methods of improving prehospital hypotension and hypoxemia,then the prognosis of TBI patients pre-and post-training for 12 months was collected and recorded.The prognostic differences of different TBI subgroups were discussed through data analysis.Results:after the training,the proportion of prehospital hypotension and hypoxemia in TBI patients decreased by 77%(8.5%vs.1.9%)and 63%(9.9%vs.3.6%,P<0.05),respectively.However,only the prognosis of moderate and severe TBI patients was improved,the proportion of patients with"good prognosis^increased by 14%(61.4%vs.70.5%,respectively)and 62%(35.6%vs.58%),and no significant effect showed in mild and critical TBI patients.Conclusion:reducing the incidence of prehospital hypoxemia and hypotension can improve the prognosis of moderate and severe TBI patients,while no significant effect on mild and critical TBI patients.展开更多
BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)patients.There is conflicting evidence on the effects of chronic anticoagulation on mortality an...BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)patients.There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.AIM To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.METHODS A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19.The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants.Secondary outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and mortality.The random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion criteria.The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P<0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease severity in COVID-19 patients.展开更多
文摘Objective: To understand the current situation of prehospital first aid knowledge, attitude and behavior of university students in Jingzhou City. Methods: A prehospital first aid knowledge questionnaire and the convenience sampling method were used to survey 307 university students in Jingzhou City. Results: The mean score of prehospital first aid knowledge of university students in Jingzhou City was 12.85 ± 2.643, the mean score of attitude was 50.73 ± 4.114, and the mean score of behavior was 39.05 ± 8.898;There was a statistically significant difference in the scores of prehospital first aid knowledge, attitude, and behavior of university students depending on whether or not they had received prehospital first aid training (P P Conclusion: Jingzhou University students have a positive attitude toward pre-hospital first aid, but the knowledge level and behavior are low, which suggests that the government, society and the school should create good conditions to promote the improvement of pre-hospital first aid knowledge and ability.
文摘Objective To investigate the influencing factors for prehospital delay in patients with acute myocardial infarction (AMI). Methods A total of 807 consecutive patients with AMI who presented to the emergency department of Beijing Anzhen Hospital were analyzed. The influence of several potential risk factors on the prehospital delay time (PDT) was evaluated by comparing patients admitted more than 2 hours after onset of chese pain with those admitted within 2 hours after onset. Results Among 807 patients, 402 came to the hospital within 2 hours while the others arrived at the hospital after 2 hours. The median PDT was 130 min. Among the potential variables, advanced age, history of diabetes mellitus, occurrence of symptom at night and use of emergency medical service significantly affected PDT by multivariate analysis. Conclusion Interventions aimed at reducing the prehospital delay in AMI should primarily focus on the awareness of the risk and help-seeking behavior of patients.
文摘BACKGROUND: Communication failure in prehospital emergency medicine can affect patient safety as it does in other areas of medicine as well. We analyzed the database of the critical incident reporting system for prehospital emergency medicine in Germany retrospectively regarding communication errors.METHODS: Experts of prehospital emergency medicine and risk management screened the database for verbal communication failure, non-verbal communication failure and missing communication at all.RESULTS: Between 2005 and 2015, 845 reports were analyzed, of which 247 reports were considered to be related to communication failure. An arbitrary classifi cation resulted in six different kinds: 1) no acknowledgement of a suggestion; 2) medication error; 3) miscommunication with dispatcher; 4) utterance heard/understood improperly; 5) missing information transfer between two persons; and 6) other communication failure.CONCLUSION: Communication defi cits can lead to critical incidents in prehospital emergency medicine and are a very important aspect in patient safety.
文摘To the Editor：Airway management is a crucial skill for emergency physician, who＇s often called to deal with difficult airways and requests for quick, simple and effective responses, as the many factors responsible for difficulties might be enhanced by emergency setting.[1] We now have many rescue devices as the LMA, I-gel, but they do not provide a definitive airway, and recent studies evaluating the use of the videolaryngoscopes in emergency show conflicting results.
文摘Objective:to investigate the effect of improving prehospital hypotension and hypoxemia on the prognosis of different subgroups of patients with traumatic brain injury(TBI).Methods:medical staff were trained about the prehospital first aid for 2 months to fully master the methods of improving prehospital hypotension and hypoxemia,then the prognosis of TBI patients pre-and post-training for 12 months was collected and recorded.The prognostic differences of different TBI subgroups were discussed through data analysis.Results:after the training,the proportion of prehospital hypotension and hypoxemia in TBI patients decreased by 77%(8.5%vs.1.9%)and 63%(9.9%vs.3.6%,P<0.05),respectively.However,only the prognosis of moderate and severe TBI patients was improved,the proportion of patients with"good prognosis^increased by 14%(61.4%vs.70.5%,respectively)and 62%(35.6%vs.58%),and no significant effect showed in mild and critical TBI patients.Conclusion:reducing the incidence of prehospital hypoxemia and hypotension can improve the prognosis of moderate and severe TBI patients,while no significant effect on mild and critical TBI patients.
文摘BACKGROUND Coagulopathy and thromboembolic events are associated with poor outcomes in coronavirus disease 2019(COVID-19)patients.There is conflicting evidence on the effects of chronic anticoagulation on mortality and severity of COVID-19 disease.AIM To summarize the body of evidence on the effects of pre-hospital anticoagulation on outcomes in COVID-19 patients.METHODS A Literature search was performed on LitCovid PubMed,WHO,and Scopus databases from inception(December 2019)till June 2023 for original studies reporting an association between prior use of anticoagulants and patient outcomes in adults with COVID-19.The primary outcome was the risk of thromboembolic events in COVID-19 patients taking anticoagulants.Secondary outcomes included COVID-19 disease severity,in terms of intensive care unit admission or invasive mechanical ventilation/intubation requirement in patients hospitalized with COVID-19 infection,and mortality.The random effects models were used to calculate crude and adjusted odds ratios(aORs)with 95%confidence intervals(95%CIs).RESULTS Forty-six observational studies met our inclusion criteria.The unadjusted analysis found no association between prior anticoagulation and thromboembolic event risk[n=43851,9 studies,odds ratio(OR)=0.67(0.22,2.07);P=0.49;I2=95%].The association between prior anticoagulation and disease severity was non-significant[n=186782;22 studies,OR=1.08(0.78,1.49);P=0.64;I2=89%].However,pre-hospital anticoagulation significantly increased all-cause mortality risk[n=207292;35 studies,OR=1.72(1.37,2.17);P<0.00001;I2=93%].Pooling adjusted estimates revealed a statistically non-significant association between pre-hospital anticoagulation and thromboembolic event risk[aOR=0.87(0.42,1.80);P=0.71],mortality[aOR=0.94(0.84,1.05);P=0.31],and disease severity[aOR=0.96(0.72,1.26);P=0.76].CONCLUSION Prehospital anticoagulation was not significantly associated with reduced risk of thromboembolic events,improved survival,and lower disease severity in COVID-19 patients.
