The Epidemiological Investigation Of The Patients Who Died Of Emergency In Suzhou ＆ The Investigation Of Different Levels Of Resuscitation Skills Of Primary Hospitals In The Rural Areas Of Suzhou

PartⅠThe Epidemiological Investigation of the Patients Who Died of Emergency in SuzhouObjective The survey was made to study the epidemiological characteristics of the patients who died of emergency in Suzhou, in order to provide basic data for the integration of medical resources and the decision of management strategies, as well as the resuscitation skills'training.Methods By means of the census method, the survey investigated the clinic information of all patients who died of emergency when being dealt with in every hospital of Suzhou from 2007/06/30 to 2009/05/31. With the guidance and help of the research group and the Quality-Control Center of Emergency Medicine in the city of Suzhou, I designed the survey form and issued the survey form to the units that were surveyed through administrative channels. Mutual cross-checks among the contents of the research evaluate the credibility of the information that was reported by the units that were surveyed.Results①Among the 2661 patients who died of emergency, there were 1895 male and 766 female, the ratio of male to female was 2.47︰1, mean age was 50.84±44.69 years old.②There were 1289 cases of death before hospitalization, occupied 48.44% of all cases.③The diseases/pathology that directly caused patients'death by order were brain hernia 764 cases, accounting for 28.71%; shock 551 cases, accounting for 20.71%; acute respiratory failure 496 cases, accounting for 18.64%; fatal arrhythmia 423 cases, accounting for 15.90%; acute heart failure 266 cases, accounting for 10.00%; severe multiple injury 109 cases, accounting for 4.10%; multiple organ dysfunction syndrome(MODS) 41 cases, accounting for 1.54%; other diseases 11 cases, accounting for 0.41%.④The main etiological factors by order were: trauma 1150 cases, accouting for 43.22%; cardiac-cerebrovascular diseases 891 cases,accounting for 33.48%; physical and chemical factors induced diseases 382 cases, accouting for 14.36%; respiratory diseases 168 cases, accounting for 6.31%; digestive diseases 36 cases, accounting for 1.35%; endocrine diseases 21 cases, accounting for 0.79%; other diseases 13 cases, accounting for 0.49%.⑤Ten top emergent diseases that directly caused patients'death by order were trauma of traffic accidents, acute coronary syndrome, cerebral hemorrhage, drowning, trauma of fall, severe brain trauma, airway obstruction, the acute exacerbation of chronic cardiac insufficiency, electric injury and acute organic phosphate poisoning.Conclusions①Among the patients who died of emergency mainly were the mid-age patients and have a high pre-hospital death rate in Suzhou;②The main causes of death were trauma, Cardiac-cerebrovascular diseases, physical and chemical factors and respiratory system diseases in Suzhou.PartⅡThe Investigation of Different Levels of Resuscitation Skills of the Primary Hospitals in the Rural Areas of SuzhouObjective The survey was made to investigate the current situation of different levels of resuscitation skills of the primary hospitals in the rural areas of Suzhou, in order to provide basic data for the integration of medical resources and the decision of management strategies, as well as the resuscitation skills'training.Methods By means of the census method, the survey investigated the development of resuscitation skills at different levels, the implementation personnel, the consumption of medical stuff and medicines commonly used for resuscitation in the primary hospitals in the past two years. With the guidance and help of the research group and the Quality-Control Center of Emergency Medicine in the city of Suzhou, I designed the survey form and issued the survey form to the units that were surveyed through administrative channels. Mutual cross-checks among the contents of the research evaluate the credibility of the information that was reported by the units that were surveyed.Results①The survey forms' actual receipt rate and pass rate was 69.47% and 96.97% respectively;②In the comparison with the resuscitation skills of trauma life support, the resuscitation skills of circulating and respiratory support at high level of the primary hospitals were relatively weak;③At the aspect of advanced airway establishment, 90.24% of endotracheal intubations were carried out by the anesthetists, 50.00% of tracheotomies were carried out by the ophthalmology & otorhinolaryngology physician, another 50.00% of tracheotomies were relied on surgical specialists.Conclusions The primary hospitals in the rural areas of Suzhou should further accelerate the construction of emergency department and strengthen the development of resuscitation skills at high level, especially in the advanced circulating and respiratory support.