Objective To elucidate the effect of first-aid fast track in triaging earthquake trauma patients by studying the earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” so as to accumulate experience in the treatment of disaster traumas. Methods A retrospective study was done on earthquake trauma patients staying in the Emergency Department of West China Hospital after “5•12 Wenchuan Earthquake” from 14:28 May 12, 2008 to 14:27 May 15, 2008. Differences in care given during the time period were analyzed. Results There were 536 earthquake trauma patients in West China Hospital within 72 hours after the earthquake. Twohundred and seven earthquake trauma patients staying in the Emergency Department had an average stay of 129 minutes during the 24 hours after the quake; 104 earthquake trauma patients staying in the Emergency Department had an average stay of 97 minutes in the second 24 hours; and 226 earthquake trauma patients staying in the Emergency Department had an average stay of 86 minutes in the third 24 hours. Each consecutive day showed shorter average stays. Conclusion The first-aid fast track not only guarantees earthquake trauma patients are saved as soon as possible but also shortens the time in the Emergency Department.
ObjectiveTo investigate nurses' attitude on the reporting of clinical adverse events and analyze its correlated factors in the Emergency Department. MethodsA total of 130 nurses in a class-3 grade-A hospital were recruited in our study by convenience sampling method during November and December 2014. The Chinese version of Reporting of Clinical Adverse Events Scale was applied to assess nurses' attitude on reporting adverse events. ResultsThe nurses' willingness to report adverse events in the Emergency Department was generally low, and the attitude scores of nurses in the triage zone, rescue zone, monitoring zone and observation zone were respectively 65.62±1.16, 65.49±0.58, 65.06±0.80, and 63.20±0.86, without any significant difference among these zones (P>0.05). The attitude scores of nurses with a seniority of 1-2, 3-5, 6-9, and ≥ 10 years were respectively 67.37±3.27, 64.49±3.98, 63.77±4.82, and 64.30±4.52, with significant differences among these seniority groups (P＜0.05). The attitude scores of nurses with a rank of nurse-in-charge, primary nurse, and nurse were respectively 61.25±4.02, 63.97±4.52, and 65.92±4.02, also with significant differences among these groups (P＜0.05). ConclusionsThe willingness of reporting clinical adverse events in emergency nurses is not high. It is necessary to strengthen the training of nurses on their cognition of adverse events and encourage reporting, thus to create a non-punishment hospital security culture.
Objective To investigate the core competencies of emergency specialized nurses and the influencing factors in Sichuan Province so as to provide a basis for improving the training systems. Methods The trainees who received specialized training in West China Hospital every March and September between 2012 and 2014 were investigated with questionnaire survey. Results A total of 270 questionnaires were given out, and 246 valid questionnaires were retrieved. The scores of emergency specialized nurses’ core competencies ranged from 165 to 258, with an average of 214.55±22.56. According to the scores, 4.88% of the emergency specialized nurses’ core competencies were at a low level, 67.07% were at a middle level and 28.5% were at a high level. The influencing factors of core competencies included education, professional title, position, level of hospitals and years of working experience in the emergency department. Conclusion Core competencies of emergency specialized nurses need to be further improved and the training systems need to be improved consistently.
Sedation and analgesia is an essential part of the emergency work. Presently, for adults, clinical assessment and application of sedation and analgesia has been gradually perfect, but in the face of pediatric patients, clinicians would always concern drug-related adverse reactions as well as a variety of uncontrollable factors, leading to reducing and even ignoring the sedation and analgesia in children. This review focuses on the current research status and relevant evidence of pediatric sedation depth and risk assessment, pain assessment, as well as the principles, application methods, advantages and disadvantages of various commonly used clinical drugs, and the aim is to provide evidence for higher quality sedation and analgesia for children.
Objective To analyze the characteristics of patients transferred by ambulances to emergency department before and after coronavirus disease 2019 epidemic, in order to improve the efficiency of emergency triage, optimize the utilization of emergency resources, and provide a reference for standardized tiered medical services in different situation. Methods The patients’ information collected through Wenjuanxing questionnaire was extracted, who were transferred by ambulances to the Emergency Department of West China Hospital of Sichuan University between December 27th, 2018 and April 28th, 2019 (before epidemic), or between December 27th, 2019 and April 28th, 2020 (during epidemic), or between December 27th, 2020 and April 28th, 2021 [in regular epidemic prevention and control period (REPCP)]. The general information, sources, reasons for referral, disease spectrum and triage levels of patients in the three periods were compared. Results There were 3993, 2252 and 1851 cases before epidemic, during epidemic, and in REPCP, respectively. The differences in gender and age among the three periods were not statistically significant (P>0.05). The percentage of referrals from tertiary hospitals in each period was 74.00%, 72.65%, and 76.12%, respectively, which was higher in REPCP than that during epidemic (P<0.05). The percentage of direct referrals from emergency department in each period was 41.00%, 42.14%, and 44.46%, respectively, which was higher in REPCP than that before epidemic (P<0.05). The percentage of two-way referrals in each period was 37.79%, 36.63%, and 34.36%, respectively, which was lower in REPCP than that before epidemic (P<0.05). During epidemic and in REPCP, the proportions of referrals due to “need for surgery” (24.72%, 27.84%, and 28.74%, respectively) and “request by family members” (49.64%, 53.33%, and 56.24%, respectively) increased compared with those before epidemic (P<0.05), while the proportion of referrals due to “critical illness” decreased compared with that before epidemic (40.20%, 35.21%, and 33.17%, respectively; P<0.05); the proportion of referrals due to “diagnosis unknown” decreased in REPCP compared with that before epidemic (15.50%, 13.90%, and 11.89%, respectively; P<0.05). The proportion of acute aortic syndromes in REPCP increased compared with that during epidemic (3.46%, 2.98%, and 4.65%, respectively; P<0.05), the proportion of trauma in REPCP increased compared with that before epidemic (13.72%, 15.76%, and 17.77%, respectively; P<0.05), and the proportion of pneumonia/acute exacerbation of chronic obstructive pulmonary disease during epidemic and in REPCP decreased compared with that before epidemic (8.44%, 3.73%, and 3.84%, respectively; P<0.05). The proportion of critically ill patients referred in each period was 72.88%, 75.58%, and 79.15%, respectively, which was the highest in REPCP (P<0.05). Conclusions The epidemic has a significant impact on emergency ambulance referrals, and emergency triage needs to be continuously optimised and improved in staff, facilities, processes and management. It is necessary to further improve the implementation of hierarchical diagnosis and treatment, strengthen information communication between referral and emergency departments of receiving hospitals, and improve referral efficiency.
Objective To analyze the complaint characteristics of emergency department of women and children’s specialized hospital, and to provide a basis for improving medical service quality, enhancing hospital management, increasing satisfaction, and reducing complaint rates in specialized hospitals. Methods Using the Healthcare Complaint Analysis Tool classification framework, a retrospective analysis was conducted on complaints from the Emergency Department of West China Second University Hospital of Sichuan University. Results The total number of complaints from 2020 to 2022 was 525, and the number of complaints had been increasing year by year. There were 196 complaints against personnel and 329 complaints against regions. There were 320 complaints related to management issues (61.0%), 143 complaints related to doctor-patient relationship issues (27.2%), and 62 complaints related to clinical issues (11.8%). The complained areas were mainly fever clinics (193 cases), and the complained personnel were mainly nurses (82 cases). Conclusion The emergency department of women and children’s specialized hospitals is different from comprehensive hospitals, and active optimization should be carried out to address the main issues. While continuously improving the level of medical technology, it is also necessary to strengthen information technology construction, optimize medical procedures, improve environmental facilities, and provide psychological support for patients and their caregivers.