2004, vol. 29, br. 4, str. 231-234
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Vreme - ključni faktor efikasnosti hitne službe
Time: A key factor of efficiency in the emergency department
aSlužba hitne medicinske pomoći, Zdravstveni centar, Zaječar bNeuropsihijatrijska služba, Zdravstveni centar, Zaječar
e-adresa: mmilicevic@ptt.yu
Sažetak
Urgentna medicina je multidisciplinarna grana medicine koja u kritično kratkom vremenskom intervalu zahteva dobro poznavanje medicinskih činjenica, besprekorno vladanje potrebnim veštinama sa najčešće izmenjenim redosledom dijagnostičkih i terapijskih procedura. Cilj rada je sagledavanje efikasnosti službe hitne medicinske pomoći (SHMP) u Zaječaru. Ispitivanu grupu su činila 242 izlaska na teren od 1. da 25. aprila 2004.god. Podaci iz urgentnog protokola za izlazak na teren obrađeni su retrogradnom analizom. Redovi hitnosti su formirani na osnovu IIS-a, (Input Information Score) - naloga za hitnu lekarsku intervenciju.Od prijema poziva do polaska ekipe na teren, za prvi red hitnosti kreće se u vremenskom intervalu do 5 minuta u gradu za 76.41% slučajeva, a u selu za 77.42 % slučajeva. Na mestu događaja u vremenskom periodu do 10 minuta stiže se za prvi red hitnosti u gradu u 78.30% slučajeva, a u selu u 35.49 % slučajeva.Ukupno prosečno vreme od poziva do intervencije u gradu je 15.55 min, a u selu je 26.03 min.U razvijenim zemljama Evrope od poziva do dolaska ekipe na mesto intervencije protekne manje od 10 minuta. S obzirom na to da se rad obavlja jednim vozilom i uglavnom sa nepotpunim sastavom turnusa, efikasnost hitne službe se smatra zadovoljavajućom. Da bi ona bila veća, potrebna je kontinuirana edukacija lekara i medicinskog osoblja u bržoj i tačnijoj trijaži. Edukacija opšte populacije o pružanju prve pomoći na mestu nesreće, o tome kako se i zbog čega poziva SHMP, bolja saradnja sa policijom i vatrogascima, kao i pronalaženje načina sankcionisanja zloupotrebe ove službe.
Abstract
Emergency Medical Aid is a multidisciplinary branch of medicine which requires swift implementation of good knowledge of medical facts in a very short period of time, impeccable special skills and procedures in setting up a diagnosis and therapy whose order is most often changed and adapted to the situation. The main aim is to see the efficiency of the emergency department in Zaječar. We analyzed 242 field outgoings in 25 days (from 1st April till 25th April 2004). A retrograde analysis was used for processing the data from the urgent protocol used for field teams. The data were analyzed according to sex, urgency, the time that passes between the call being received and the team setting out and the team arriving on the spot. The urgency list was formed according to the Input Information Score - orders for urgent medical interventions. Time as a factor of efficiency was measured in minutes. From the call-receiving moment to the starting-team moment, for the highest priority cases we run in five minutes in town in 76,41%, and for the cases in villages in 77,42%. On-the-spot time for the highest priority cases was needed 10 minutes in 78,30% for the cases in town, and in 35,49% in village. Speaking in minutes, time from patient call to arriving on-the-spot was 15,55 minutes in town, and 26,03 minutes in village. The efficiency of the Emergency Department in Zaječar is satisfactory, considering that we have only one Ambulance which is active at the moment. In order to increase the efficiency even more, better education of the staff is necessary. It is also necessary to educate the public about giving the first aid, why and when the Emergency Department is to be called for help, as well as finding means for sanctioning the abuse of the department.
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