美国紧急医疗服务指南中的劳累性中暑最佳做法

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
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引用次数: 0

摘要

背景劳累性热病(EHIs),特别是劳累性中暑(EHS),是美国劳动者非意外死亡的首要原因。本文旨在量化和识别现有的全州紧急医疗服务指南,确定全州紧急医疗服务指南是否改善了劳动者中暑的治疗效果,并研究当全州紧急医疗服务指南中存在最佳实践时,劳动者中暑死亡的几率。方法 研究了辅助医务人员协议提供者数据库和官方急救服务网站,以确定美国哪些州制定了全州范围的急救服务指南,并对制定了全州范围指南的州进行了双向χ2分析和相关的几率比分析,研究了EHI结果。全州范围内的急救服务指南由三位独立评审员对 EHS 最佳实践进行了内容分析。结果在 50 个州、哥伦比亚特区和波多黎各中,57.7%(n = 30)有全州范围的 EMS 指南,42.3%(n = 22)没有。推荐使用 CWI 作为冷却方法的州与不推荐使用 CWI 作为冷却方法的州在 EHI 结果上存在明显差异 (χ21 = 3.336; p = 0.049)。如果 CWI 未被纳入紧急医疗服务指南,劳动者的 EHS 死亡几率要高出 3.0 倍。没有 CFTS 的州在 EHI 结果方面存在重大关联 (χ21 = 5.051; p = 0.017)。结论当全州急救指南中包括 CWI 和 CFTS 时,劳动者死于 EHS 的几率分别降低了 3.0 倍和 3.7 倍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exertional Heat Stroke Best Practices in U.S. Emergency Medical Services Guidelines

Background

Exertional heat illnesses (EHIs), specifically exertional heat stroke (EHS), are a top cause of nonaccidental death among U.S. laborers. EHS management requires coordination between Emergency Medical Services (EMS) and workplace officials to implement cold water immersion (CWI) and cool first, transport second (CFTS).

Objective

The purpose of this article was to quantify and identify existing statewide EMS guidelines, determine whether statewide EHS guidelines improved outcomes for EHIs in laborers, and examine the odds of laborer EHS fatalities when best practices are present in EMS statewide guidelines.

Methods

The Paramedic Protocol Provider database and official EMS websites were examined to determine which U.S. states had statewide EMS guidelines and, for those with statewide guidelines, a two-way χ2 analysis with associated odds ratios examined EHI outcomes. Statewide EMS guidelines underwent content analysis by three independent reviewers regarding EHS best practices. Significance was set a priori at p < 0.05.

Results

Among 50 states, the District of Columbia, and Puerto Rico, 57.7% (n = 30) had statewide EMS guidelines and 42.3% (n = 22) did not. There was a significant association for EHI outcome for states recommending CWI as a cooling method vs. those that did not (χ21 = 3.336; p = 0.049). The odds of EHS deaths for laborers were 3.0 times higher if CWI was not included in the EMS guidelines. There was a significant association in EHI outcomes for states without CFTS (χ21 = 5.051; p = 0.017). The odds of laborers dying from EHS were 3.7 times higher in states without CFTS.

Conclusions

Laborers are 3.0 and 3.7 times less likely to die from EHS when statewide EMS guidelines include CWI and CFTS, respectively.

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来源期刊
Journal of Emergency Medicine
Journal of Emergency Medicine 医学-急救医学
CiteScore
2.40
自引率
6.70%
发文量
339
审稿时长
2-4 weeks
期刊介绍: The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine
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