医疗优先分级调派系统在院前心脏骤停事件中应用现况分析
Chinese Journal of Critical Care Medicine(2015)
Abstract
目的:分析医疗优先分级调派系统( medical priority dispatch system, MPDS)在院前心脏骤停( out of hospital cardiac arrest, OHCA)事件中的应用现况。方法对照2012-06-26~2013-12-26院前直属分站出诊的1658份现场心脏骤停病历,听取相关调度员接警录音,收集相关数据。结果1658例心脏骤停事件中,调度员应用MPDS判断病情958例,电话医学指导370例;MPDS对院前心脏骤停事件的识别特异度为99.9%,敏感度为49.1%;发病地点(χ2=2.872,P=0.000;χ2=1.772,P=0.000)、报警人性别(χ2=9.763,P=0.002;χ2=8.308,P=0.004)与是否为患者家属(χ2=2.660,P=0.000;χ2=1.461,P=0.000)、是否属于110联动事件(χ2=4.414,P=0.000;χ2=1.169,P=0.000)分别与是否应用MPDS询问病情、实施医学指导差异有统计学意义;应用MPDS判断病情、电话医学指导与心脏骤停患者的抢救效果之间差异无统计学意义。结论 MPDS对OHCA的识别特异度较高,但仍存在薄弱环节,需要从加强应用管理、重视公众宣传、改进培训科目及开展科学研究四方面持续改进,以提高病种的识别敏感度。
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Key words
Medical priority dispatch system ( MPDS),Out-of-hospital cardiac arrest ( OHCA),Cardio-pulmonary resuscitation ( CPR),Medical instruction by telephone,Sensitivity,Specificity
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