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題名 | 以派遣員協助創傷病人到院前之簡易意識評估=A Simple Method for Pre-hospital Dispatcher-aided Consciousness Assessment in Trauma Patients |
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作者 | 紀志賢; 蔡明哲; 莊佳璋; 吳明和; 蔡良敏; | 書刊名 | 中華民國急救加護醫學會雜誌 |
卷期 | 10:2 1999.06[民88.06] |
頁次 | 頁55-60 |
分類號 | 419.53 |
關鍵詞 | 意識; 派遣員; 格拉斯哥昏迷指數; 到院前; 創傷; Consciousness; Dispatcher; Glasgow Coma Scale; Pre-hospital; Trauma; |
語文 | 中文(Chinese) |
中文摘要 | 有經驗及訓練有素的救護人員可以純熟的利用格拉斯哥昏迷指數(Glasgow coma Scale, GCS)進行病患意識評估,但是對一位非專業或不經常從事救護工作的人員而言,實際上GCS幾乎無法應用。本前瞻性研究的目的就是嘗試經由119指揮中心的派遣員,利用簡易的指今,來協助救護人員進行簡單到院前意識評估。研究以1993年11月29日至1994年1月17目,40天期問所有臺南市119出勤到院前創傷之病患及無經驗之救護技術員為對象。根據1993年美國外科醫學會高級創傷救命術(Advance Trauma Life Support, ATLS)課程發展之意識評量簡單的流程:若病忠運動分數=6分是即為清醒(GCS13-15),運動分數<6者、睜眼分數>l(GCS9-12),否則即為昏迷(GCS3-8)。結果顯示,進入分析之有效病例為364例,利用119指揮中心的護理人員以簡化的指令協助到院前意識狀況的評估,其誤差率約為11%,而低估病患病情的情形為3.3%。80%的誤判是發生在頭部外傷的病志,而低估病況的12個病例,全部為頭部外傷的病患。本研究之結論為:針對沒有經驗的人而言,以現場聽從指揮中心派遣員的電話指示來做簡單病患意識評估是到院前傷病評估的另一種選擇。 |
英文摘要 | The Glasgow coma scale (GCS) was used accurately by experienced and highly trained users, but inexperienced users made consistent errors. The purpose of this prospective study is to develop a simplified consciousness assessment method for inexperienced health provider or bystander. We developed the consciousness evaluation protocol according to the Advanced Trauma Lift Support. A clear consciousness (GCS13-15) is defined as GCS motor response equal to 6. For those whose motor score less than 6, GCS eye opening score greater than 1 were classified as consciousness disturbance (GCS9-12). The study was conducted from 29 November 1993 to 17 January 1994. A dispatcher-aided consciousness assessment was made for the trauma patients transported by 119 ambulance staffed by firefighter. During forty days periods, 364 trauma patients were enrolled. Dispatcher telephone aided prehospital consciousness assessment made 11% incorrect estimation. Of them, 3.3% were under-estimation. 80% of the overall error was head injury victims. All of the twelve-underestimation patients were head-injured patients. In conclusion, this simplified dispatcher-aided prehospital consciousness could be an alternative method for inexperienced provider on the scene. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。