Dead on Arrival Study in Kaohsiung Area

探討高雄地區到院死亡個案

王正信(Jeng-Shing Wang) ； 程淑華(Shu-Hua Cheng) ； 呂麗貞(Lih-Jen Leu) ； 許秉毅(Ping-I Hsu) ； 柯成國(Cheng-Guo Ker) ； 黃英傑(Ying C. Huang) ； 張進富(Chin-Fu Chang) ； 林尚穎(Shung-Eing Lin) ； 陳正雄(Jun-Hsung Chen) ； 阮仲垠(Chung-Yin Yuan) ； 林廷燦(Mike L)

《The Kaohsiung Journal of Medical Sciences》 11卷1期 (1995/01) Pp. 21-26

https://doi.org/10.6452/KJMS.199501.0021

摘要

到院死亡對多數醫護人員及家人是一個極大悲痛，雖然多數到院死亡不論有無潛在疾病為前導因素，都是不可預期而且突然，但是很少文章探討這個主題。
從民國八十二年一月一日到八十二年十二月三十一日，高雄地區共有四百八十七位到院死亡病人被送到四家大醫院，我們用問卷形式進行回溯性探討。
發生率約0.22%，男女比率為2.25，同時最大的年齡組別是61到75歲，多數病人被家人用非救護車交通工具送到附近雇院。從心跳停止到送達醫院的時間不好估計，同時送院時的心率多數是心跳收縮不全。到院死亡病人只有1.44%存活，同時9.24%對復甦術有反應。31.42%病人無明顯病因，40.04%為非創傷死因，28.54%為創傷死因。在過去病史可回溯的病人中，多數潛在疾病均被專科醫師規則治療。雖然從民國七十九年我國緊急醫療網開始創立，但是仍然有些缺失。我們必須強調心肺復甦術的大眾教育，緊急醫療網的容易啟動，及醫院的適當處理。經由到院前救護，緊急醫痘網及院內治療的改善，到院死亡病人才會減少。

並列摘要

Dead on arrival (DOA) is a distressful situation for most medical personnel and families. There are few papers about this topic in Taiwan though most DOAs are unepected and sudden with or without underlying disease as predisposing factors.
From January 1, 1993 to December 31, 1993, 487DOA patients were sent to 4 large hospitals in the Kaohsiung area (including Kaohsiung City and Kaohsiung County). A retrospective study was carried out through questionnaires.
The incidence was 0.22%, the male to female ratio was 2.25, and the largest age group was 61 to 75 years old. Most patients were sent to nearby hospitals and sent by non-medical personnel with non-ambulance motor vehicles. It is hard to define the exact time from arrest to arrival at the hospital, but the initial cardiac rhythm was mostly asystole. Only 1.44% of DOA patients survived and only 9.24% responded to resuscitation. About 31.42% of patients had no evident cause of death, 40.04% non-trauma deaths, and 28.54% trauma deaths. Most of the underlying diseases were treated regularly by medical specialists if past history could be traced.
Though our emergency medical service system (EMSS) has been active since 1990, there are still several drawbacks. Public education of cardiopulmonary resuscitation, easy access to EMSS, and appropriate management in hospitals must be stressed. With the improvement of prehospital care, EMSS, and in-hospital, care, there will be a decrease in DOA patients.

並列關鍵字

ead on arrival (DOA) ； emdergency medical service system (EMSS) ； emergency medical service (EMS)