- 期刊
- OpenAccess
【論文摘要】澎湖二三級離島經海路轉診個案現況分析
【論文摘要】The medical characteristics of the patients underwent emergency transportation by sea from remote islands to the main island of Penghu from 2019 to 2021
摘要
介紹：澎湖二三級離島經海路轉診的個案經常需要由離島的救護人員執行到院前及院際間轉診救護服務，再經澎湖本島的救護人員接駁至醫院進階處置。藉由探討經海路轉診個案的就醫特徵來制定救護人員教育訓練的方針。方式：本研究為觀察性研究，收集澎湖縣自2019年1月1日至2021年12月31日三年間二三級離島經海路轉診個案資料如傷病患基本資料、傷情、轉出時間、收治醫院與動向進行分析，其中分類變量以數字和百分比表示。結果：三年期間經海路轉診個案為311人次，其年齡分佈以老人（>64歲）（54.3%）為大宗，其次是成人（18－64歲）（40.2%）、兒童與青少年較少（1－17歲）（5.5%）。男性稍多於女性（51.8%vs48.2%）。非創個案是創傷個案數的3.2倍。心血管疾病（16.1%）、感染疾病（14.5%）與神經疾病（12.2%）、腸胃疾病（11.9%）、呼吸疾病（10.0％）是主要的非創傷傷情，而嚴重及中度的創傷傷情分別為12.9%跟10.9%。到院前心跳停止救回經海路轉出的個案僅5件（1.9%）。十一個離島中以鳥嶼（25.1%）、吉貝（17.4%）、望安（16.7%）、七美（15.4%）、將軍（8.3%）為主。轉送季節以夏最多（28.3%），冬季最少（19.6%）。轉送時段以小夜（43.4%）及白班（40.2%）為主，大夜時段轉出最少（15.1%）。海陸轉送方式以包漁船（55.9%）跟海巡船隻（40.0%）運送為主。部立澎湖醫院以及三總澎湖分院為主要收治醫院，收治比例一樣（49.8%）。患者經醫院治療後，雖動向不詳個案佔16.4%，仍有45％的個案都需要住院治療，32.5％經急診檢查及處置後出院，需再轉診僅3.5%，僅1.6％死亡。結論：高齡及非創疾病的評估及處置是二三級離島經海運轉診個案的重要議題，可作為澎湖縣救護人員教育訓練的方針。
關鍵字
無資料並列摘要
Introduction: For emergency medical technicians (EMTs), managing those patients underwent emergency transportation by sea from remote islands to the main island of Penghu often are major and critical issues. By exploring the medical characteristics of them, we are able to optimally establish the training strategy for EMTs. Methods: This retrospective cross-sectional observation study was conducted using the Penghu Retrieval Registry System from January 1, 2019 to December 31, 2021. The medical characteristics included patient's basic information, diagnosis, the receiving hospital, final disposition of hospital, and timeline. Descriptive analysis was used in this study in which categorical variables were presented as numbers and percentages. Results: A total of 311 patients were enrolled in this study. Regarding the basic information, 54.3% patients were in elderly, following by adults (40.2%) and children (5.5%). Male were slightly more than female (51.8% versus 48.2%). About diagnosis, the incidence of non-traumatic was 3.2 times higher than that of traumatic situation. The most common diagnosis categories were cardiovascular (16.1%), following by infection (14,5%), neurologic (12.2%), gastrointestinal (11.9%), and severe and moderate trauma (12.9% and 10.9%, respectively). The patients with out of hospital cardiac arrest at the transferring islands were five (1.9%). Of 11 remote islands, Niaoyu (25.1%), Jibei (17.4%), Wang-an (16.7%), Qimei(15.4%), Jiangao (8.3%) were predominant transferring sites. Regarding the timeline, the season of transportation was the most in summer (28.3%) and the least in winter (19.6%). The transfer shift of a day was dominated by evening (43.4%) and day (40.2%). Fishing boats (55.9%) and the ships of coast guard administration (40.0%) were the main type of transportation. There were two receiving hospitals in the main land of Penghu with the same receiving rate. Regarding the disposition after hospital, although 16.4% of the patients were unknown, 45% still required hospitalization, 32.5% were discharged from emergency department, 3.5% were referred again, and only 1.6% died. Conclusions: For the patients underwent emergency transportation by sea, managing elderly and non-traumatic situation can be used as a strategy for the education and training of EMTs in Penghu County.