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頁籤選單縮合
| 題 名 | 運用通訊科技提升緊急醫療服務品質:一個偏鄉地區醫院的經驗=Enhancing the Quality of Emergency Medical Service through Communication Technology: The Experience of a Rural Hospital |
|---|---|
| 作 者 | 洪順世; 洪加芳; 吳姵萱; 洪嬿淇; 周心玉; 王致剴; 沈德群; 曾俊凱; 莊碧焜; | 書刊名 | 台灣急重症醫學雜誌 |
| 卷 期 | 10:3 2025.09[民114.09] |
| 頁 次 | 頁95-101 |
| 分類號 | 419.5 |
| 關鍵詞 | 通訊科技; 院外心臟驟停; ST段升高型心肌梗塞; 急性缺血性腦中風; Communication technology; Out-of-hospital cardiac arrest; OHCA; ST-elevation myocardial infarction; STEMI; Acute ischemic stroke; AIS; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 背景:眾所周知,院外心臟驟停、ST 段升高型心肌梗塞及急性缺血性中風均為具 有黃金治療時間的急症。可惜在醫療資源缺乏的偏鄉地區,要迅速治療這些急症的難 度頗高。因此,在偏鄉建立完善的緊急醫療服務系統至關重要。 方法:一個偏鄉的地區醫院自 2023 年起嘗試與周邊 9 個消防分隊合作,建立通訊 平台,提供即時影像與檢查判讀和到院前醫療建議,同時預警院內的相關醫療團隊待 命及早接手照護病人。本研究將評估有使用與未使用該通訊平台的院外心臟驟停、 ST 段升高型心肌梗塞及急性缺血性中風病人的臨床照護成效。 結果:自 2023 年 1 月至 2024 年 3 月,在案例組(使用通訊平台)中,共有 13 例 院外心臟驟停,其中 9 名患者(69.2%)達成恢復自主循環;對照組(未使用通訊平台) 則有 123 例院外心臟驟停,其中 22 名患者(17.9%)達成恢復自主循環(p < 0.0001)。 在 ST 段升高型心肌梗塞患者中,案例組有 8 名患者接受緊急心導管治療,其中 6 名患者(75%)達成 90 分鐘內導管到達阻塞處;最終 7 名患者存活出院。對照組 中,共有 33 名患者接受緊急心導管治療,其中 18 名患者(54.5%)達成 90 分鐘內 導管到達阻塞處;最終 30 名患者存活出院。對於急性缺血性中風患者,案例組有 7 名患者符合溶栓治療資格,且 7 名患者(100%)皆於 60 分鐘內完成溶栓治療,平 均給藥時間為 29.9 分鐘;對照組則有 30 名患者符合溶栓治療資格,其中 24 名患者 (80%)於 60 分鐘內完成溶栓治療,平均給藥時間為 54.1 分鐘(p < 0.0001)。 結論:通訊科技的應用可以提升緊急醫療服務的品質,縮短患者處理時間並改善 治療效果。未來,應該更進一步拓展遠距醫療服務技術與範疇,將醫療照護延伸至更 前線的救護現場。 |
| 英文摘要 | Background: It is well known that out-of-hospital cardiac arrest (OHCA), acute ST- elevation myocardial infarction (STEMI), and acute ischemic stroke (AIS) are time-sensitive emergencies that require rapid intervention, particularly in rural areas. Establishing a comprehensive emergency medical service is therefore essential. Methods: Since 2023, a local hospital has partnered with 9 nearby fire brigades to create a communication platform, which provides real-time image interpretation and pre-hospital medical advice. This platform also helps expedite the readiness of the hospital’s medical team to take over patient care. We evaluated the outcomes of OHCA, STEMI, and AIS cases with and without the use of the communication platform (case group and comparison group). Results: From January 2023 to March 2024, in the case group, there were 13 OHCA cases, with 9 patients (69.2%) achieving return of spontaneous circulation (ROSC). In the comparison group, there were 123 OHCA cases, with 22 patients (17.9%) achieving ROSC. In the case group, 8 STEMI patients underwent emergency cardiac catheterization, with 6 patients (75%) achieving door-to-wire time within 90 minutes; 7 patients survived to discharge. In the comparison group, 33 STEMI patients underwent emergency cardiac catheterization, with 18 patients (54.5%) achieving door-to-wire time within 90 minutes; 30 patients survived to discharge. In the case group, 7 AIS patients were eligible for thrombolytic therapy, and all 7 patients (100%) received the therapy within 60 minutes, with an average administration time of 29.9 minutes. In the comparison group, 30 AIS patients were eligible for thrombolytic therapy, and 24 patients (80%) received the therapy within 60 minutes, with an average administration time of 54.1 minutes. Conclusions: Communication technology can enhance both pre-hospital rescue and post-hospital care by reducing patient handling time and improving treatment outcomes. In the future, we aim to develop more extensive services, extending medical care to the front lines. |
本系統中英文摘要資訊取自各篇刊載內容。