대학병원 응급의료센터로 전원되는 환자에 대한 연구 : 경북대학교병원 응급의료센터를 중심으로 = A Study on patients transferred to emergency medical center of university hospital

다국어 초록 (Multilingual Abstract)

Background: To provide basic data to help construct regional EMSS
Method: Using preformed questionnaire, authors investigated prospectively data of 214 patients transferred directly to emergency medical center from other hospitals from May 11 to June 10, 1998.
Results:
1. Total 214 patients were transferred directly to the emergency medical center of KNUH (14.4% of total), and 63.5% of patients excluding children were non-traumatic patients.
2. The peak age group was 5th decade (19.6%) with mean age of 49.6 years old. The male to female ratio was 1.8:1.
3. The period between 08:00 to 16:00 was the most frequent arrival time of transfer patients (42.5%), and the proportion of patients for surgical departments were more common than those for other departments (53.7%).
4. The majority of patients were transferred from secondary hospitals (91.6%), but among them the proportion of mild non-traumatic and mild traumatic patients was 52.3%, and 72.0%.
5. The decision-maker for transfer was a patient himself or family members in 32.3% of severe and 26.8% of mild non-traumatic patients, compared with 37.5% of severe and 26.8% of mild traumatic patients.
6. The physician-to-physician communication prior to the patient's transfer was not carried out in 90.8% of severe and 85.9% of mild non-traumatic patients, compared with 75.0% of severe and 67.0% of mild traumatic patients.
7. The hospital ambulance was the most common mode of transfer (64.5%), but non-emergency vehicles such as a taxi or a private car was used for transfer in 21.5% of severe non-traumatic patients, and 12.5% in severe traumatic patients.
8. Transfer accompanied by medical personnel took place in 15.4% of severe non-traumatic patients, 25.0% in severe traumatic patients, and in 27.0% of severe non-traumatic patients, and 44.4% in severe traumatic patients transferred by hospital ambulance.
9. Transfer took less than 1 hour in 66.9% of non-traumatic patients, and 45.2% of traumatic patients, but it took 1 hour or more in 27.7% of severe non-traumatic patients, and 43.7% of severe traumatic patients.
10. Transfer record accompanied the patient in 90.2% of total, but radiologic film and results of laboratory tests did not in 36.9% and 56.9% of severe non-traumatic patients, and in 12.5% and 43.7% of severe traumatic patients.
Conclusion: It is considered that an appropriate triage system, interhospital transfer guidelines, good transfer records, cooperative interhospital communication, emergency medical information center, public information with education about regional EMSS, improvement of equipment in ambulance, and training of emergency personnel are necessary for effective and well-organized EMSS.