Preliminary Study On Pre-hospital Trauma First Aid Diagnosis And Treatment

Background:The number of trauma patients in the world exceeds 10 million per year,accounting for 8.8% of the total number of deaths in the world[1].In China’s urban and rural areas,the wounds have been the top 5 causes of death[2].In 2017,the number of trauma patients in China was 62 million,and the number of traumatic deaths was about 70-800,000 people,severe trauma has become the first cause of disability and death in young adults under 45 years of age.Therefore,improving the efficiency of pre-hospital first aid for trauma is one of the top priorities of emergency doctors[3,4].However,compared with other disciplines,pre-hospital first aid is relatively lagging behind in terms of teacher strength,scientific and technological input,and academic concepts.Pre-hospital first-aid is a horizontal subject.Pre-hospital emergency medical personnel need to master the first-aid knowledge and skills of multiple systems and multiple parts in order to complete the first medical contact with the rescuer more effectively.The professional quality of emergency medical personnel is still difficult to meet the requirements of comprehensive development,and for the new generation of pre-hospital emergency personnel,the training of the pre-hospital three bases will also be a long process.Purpose:In view of the pre-hospital first-aid situation,this study attempts to integrate the pre-hospital trauma information,collect the original real data,and compile the evaluation formula that meets the pre-hospital trauma first aid,which is conducive to the preliminary establishment of the pre-hospital trauma first aid diagnosis and treatment system.Collect information about pre-hospital trauma records,record real-time data of pre-hospital trauma records,and assist pre-hospital medical staff to conduct injury assessment and operation,improve the rational disposal of the first medical contact,and complete pre-hospital trauma first aid under simulated conditions.To provide possible assistance for computer-assisted pre-injury first-aid work and to improve pre-hospital related medical records.Method: Collect the diagnosis name and diagnostic basis of traumatic diseases of the head,chest,abdomen and extremities,including traumatic factors,trauma sites,characteristic symptoms and signs,etc.,and transform and rearrange the diagnostic basis of each injury,so that the diagnostic basis after transformation can be Fully reflected in related symptoms and signs,making it more suitable for trauma first aid in prehospital environment,and adding reasonable "first aid technical operation" tips in the pre-hospital injury assessment to guide the actual operation of pre-hospital medical workers,each trauma The information is recorded in the form of tick and add remarks.By matching the content with the pre-hospital trauma assessment formula,the work of assisting pre-hospital trauma diagnosis and treatment is completed,and the system is self-contained.From the emergency HIS system of our hospital,500 traumatic medical records were collected from January to Octoberr 2018,and 180 pre-hospital medical records including single-site injury or single-site injury were included,including head injury,chest injury,abdominal injury,and limbs.The medical record information of 45 patients in each injury,the diagnosis results in the emergency hospital,and related operations were completed and used as the evaluation criteria.The pre-hospital emergency personnel were divided into two groups,one consisting of doctors and nurses who obtained the qualifications for practicing in the emergency department for more than one year,and one record personnel.The two groups of experimental personnel passed the CRASH PIAN sequence for injury and consultation.The medical records were collected.The first group of pre-hospital emergency personnel recorded the medical records of the injured patients through the pre-hospital trauma-assisted diagnosis and treatment system,and carried out related operations according to the prompts.The other group relied on on-site decision-making for medical treatment.According to the extracted medical record information,the pre-hospital injury environment simulation was carried out,and the pre-hospital trauma assessment results and related operations of the above two groups were recorded in 10 minutes,and compared with the evaluation criteria.The data results were statistically analyzed using SPSS 21.0,P < The difference was considered statistically significant at 0.05.Result:Among the 180 patients with pre-hospital trauma simulation,136 cases were correctly diagnosed by the first group of pre-hospital trauma-assisted diagnosis and treatment system,and 146 cases were correctly completed.The second group correctly diagnosed 107 cases with the pre-injury evaluation method of the on-site decision-making center,correctly completed.103 cases were operated.The positive rate of the first group was 75.56%,the positive rate of the second group was 59.44%,the positive rate was 45.56%,the negative rate was 10.56%,and the calculated c2 was 10.65,P <0.05.The positive rate of the first group of trauma first aid operation was 81.11%,the positive rate of the second group of trauma first aid operation was 57.22%,the common operation positive rate was 46.67%,the common operation negative rate was 8.33%,and the calculated c2 value was 22.83,P <0.05.The pre-hospital assessment and diagnosis rate of the pre-hospital trauma-assisted diagnosis and treatment system proposed in this study is higher than the on-site decision-making evaluation method,and the specificity is not lower than the on-site decision-making.Pre-hospital assessment,and can prompt the emergency physician to take pre-hospital trauma first-aid operations on site.Discuss:At present,there is no relevant report on the pre-hospital trauma-assisted diagnosis and treatment system,and most of the pre-hospital first-aid use of the information of the pre-hospital medical records or the post-hospital injury and on-site first-aid information collection mode,leading to incomplete information on pre-hospital trauma medical records.Delays in the development of in-hospital treatment programs.This study is based on the current pre-hospital trauma first-aid status of most medical units.Through the integration and rearrangement of pre-hospital trauma conditions and diagnostic keywords,and the human anatomy,computer technology is used to optimize or simplify pre-hospital trauma assessment.System,more standardized pre-hospital trauma treatment,improve the pre-hospital trauma electronic medical record system,real-time in-hospital first-aid information sharing,providing a new guiding role for the development of pre-hospital emergency services in China.The research of this project belongs to independent development.At present,there is no relevant pre-hospital trauma assessment diagnosis and treatment data for reference and correction.Therefore,there are many defects in the pre-hospital trauma disease collection,pre-hospital trauma information setting and pre-hospital trauma assessment diagnosis formula.Even the error occurred,and the study was conducted to simulate the pre-hospital trauma scenario.There was a bias in the description of each medical record,sample size setting and trauma information.It is necessary to continue to improve the project research content in order to achieve the practical application of pre-hospital trauma first aid.the goal of.Conclusion:The pre-hospital trauma-assisted assessment diagnosis and treatment system can complete the pre-hospital assessment and diagnosis work in the simulated situation,and prompts the reasonable pre-hospital emergency operation.In view of the complexity and diversity of trauma first aid,the system is still in the initial stage of research and development,and various injury assessment systems are still incomplete.More traumatic medical records need to be included for scientific experimental analysis.