Üniversite acil servisine 112 ambulans ile başvuran hastaların uygunluk düzeyinin değerlendirilmesi
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Tarih
2022
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Acil sağlık hizmetlerinin uygunsuz, acil olmayan sebeplerle kullanılması evrensel bir sorundur. Acil servisimize 112 ambulansı ile getirilen hastaların, üniversite acil servisine getirilme gerekliliği ve dolaylı yoldan ambulans kullanım uygunluğunu değerlendirdiğimiz çalışmamızın hastane öncesi ve sonrası acil sağlık hizmetlerinin daha etkin kullanımı için faydalı olacağını düşünmekteyiz. Metod: Çalışmamız tanımlayıcı-kesitsel bir çalışmadır. Retrospektif ve prospektif olarak izlenmiştir. Çalışmamıza 112 ambulans ile başvuran ve ambulans kayıt formu temin edilebilen 3731 hasta dahil edilmiştir. Hastaların çalışmaya dahil edilen bilgileri için 112 ambulans müdahale formu ve hastanemizin otomasyon sisteminden yararlanılmıştır. Bulgular: Çalışmaya dahil edilen hastalardan %60,9'u erkek, tüm hastaların yaş ortalaması 47,02 idi. 18 yaş üstü hastalar %84,6'lık bir kısmı oluşturmaktaydı. Hastaların %66,2'sinin SSK sağlık güvencesine sahipti. 112 tarafından en sık konulan tanı/ön tanılar düşme, trafik kazası ve göğüs ağrısı olarak görüldü. 112 ve acil servis tanı/ön tanıları incelendiğinde cinsiyete ve yaşa göre istatistiksel olarak anlamlı düzeyde fark olduğu görüldü (p=0,001). Hastaların 112 tarafından ölçülen ve acil serviste ölçülen vital bulgularının değerleri karşılaştırıldı, 112 tarafından ölçülen sistolik ve diyastolik kan basıncı ve nabız acil serviste ölçülen değerlere kıyasla istatistiksel olarak anlamlı düzeyde yüksek gözlendi. Hastaların sonlanım verileri incelendi. Taburcu olanların oranı %58, eksitus olanların oranı ise %1,4 olarak gözlendi. Yoğun bakım ünitesi yatışlarında en yüksek oranın acil servis yoğun bakım, servis yatışlarında ise ortopedi servisi olduğu görüldü. Hastaların 112 tarafından alındıkları yerler incelendiğinde %18'inin dış merkez (sağlık kurumu), %80,9'unun ev-olay yerinden olduğu gözlendi. Sonuç: Yaş, cinsiyet, sağlık güvencesi gibi demografik özellikler acil ambulans hizmetleri kullanımında etkili rol oynamaktadır. 112 ile getirilen hastalar içinde büyük bir orana sahip olan trafik kazası ve iş kazası gibi önlenebilir durumlar için gerekli çalışmaların yapılması hayati önem taşımaktadır. Hastane öncesi sağlık personeli vital bulguların ölçümünün önemi konusunda eğitilmelidir. Çalışmamızda herhangi bir triyaj kodu belirtilmeyen hastaların oranı yüksek bulunmuştur. 112 çalışanları bu konuda bilinçlendirilmelidir. Uygunsuz ambulans kullanımı ve buna bağlı gelişen yüksek taburculuk durumu, sağlık sistemi ile alakalı önemli sorunlarından biridir. 112 aracılığıyla yapılan sevklerde gerekli koordinasyon ve iş birliğinin sağlanması gereksiz sevkleri azaltarak kaynakların doğru kullanılmasına katkı sağlayacaktır.
Inappropriate use of emergency health services for the non-emergent issues is a universal problem. We think that our study, in which we evaluated the necessity of bringing the patients brought to our emergency department by 112 ambulance to the university emergency department and indirectly the suitability of ambulance use, will be beneficial for more effective use of pre- and post-hospital emergency health services. Method: Our study is a descriptive-cross-sectional study. Subjects followed retrospectively and prospectively. 3731 patients conducted to this study whoes accepted with 112 ambulances. Ambulance registration form was taken from all participiants. The automation system of our hospital was used for obtaining data. Results: 60.9% of the participiants were male, and the mean age of all participiants was 47,02. Patients over the age of 18 comprised 84.6%. 66.2% of the patients had SSK health insurance. The most common diagnoses/prediagnoses made by 112 were falling, traffic accident and chest pain. 112 and emergency service when the diagnosis/prediagnoses were examined, it was seen that there was a statistically significant difference according to gender and age (p=0.001) . The vital signs of the patients measured by 112 and measured in the emergency room were compared, and the systolic and diastolic blood pressure and heart rate measured by the 112 were statistically significantly higher than the values measured in the emergency room. Outcome data of the patients were analyzed. The rate of those who were discharged was 58%, and the rate of those who died was 1.4%. It was observed that the highest rate (43.6%) in intensive care unit admissions was in the emergency service intensive care unit, and 38.2% in the service hospitalizations in the orthopedics service. When the places where the patients were taken by 112 were examined, it was observed that 18% were from an external center (health institution) and 80.9% were from home-crime places. Conclusion: Demographic features such as age, gender, health insurance play an effective role in the use of emergency ambulance services. It is vital to carry out the necessary studies for preventable situations such as traffic accidents and work accidents, which have a large proportion of patients brought by 112. Pre-hospital healthcare personel should be educated about the importance of measuring vital signs. In our study, the rate of patients who did not specify any triage code was found to be high. 112 employees should be made aware of this issue. Improper use of ambulance and high discharge status due to this is one of the important problems related to the health system. Providing the necessary coordination and cooperation in the referrals made through 112 will contribute to the correct use of resources by reducing unnecessary referrals.
Inappropriate use of emergency health services for the non-emergent issues is a universal problem. We think that our study, in which we evaluated the necessity of bringing the patients brought to our emergency department by 112 ambulance to the university emergency department and indirectly the suitability of ambulance use, will be beneficial for more effective use of pre- and post-hospital emergency health services. Method: Our study is a descriptive-cross-sectional study. Subjects followed retrospectively and prospectively. 3731 patients conducted to this study whoes accepted with 112 ambulances. Ambulance registration form was taken from all participiants. The automation system of our hospital was used for obtaining data. Results: 60.9% of the participiants were male, and the mean age of all participiants was 47,02. Patients over the age of 18 comprised 84.6%. 66.2% of the patients had SSK health insurance. The most common diagnoses/prediagnoses made by 112 were falling, traffic accident and chest pain. 112 and emergency service when the diagnosis/prediagnoses were examined, it was seen that there was a statistically significant difference according to gender and age (p=0.001) . The vital signs of the patients measured by 112 and measured in the emergency room were compared, and the systolic and diastolic blood pressure and heart rate measured by the 112 were statistically significantly higher than the values measured in the emergency room. Outcome data of the patients were analyzed. The rate of those who were discharged was 58%, and the rate of those who died was 1.4%. It was observed that the highest rate (43.6%) in intensive care unit admissions was in the emergency service intensive care unit, and 38.2% in the service hospitalizations in the orthopedics service. When the places where the patients were taken by 112 were examined, it was observed that 18% were from an external center (health institution) and 80.9% were from home-crime places. Conclusion: Demographic features such as age, gender, health insurance play an effective role in the use of emergency ambulance services. It is vital to carry out the necessary studies for preventable situations such as traffic accidents and work accidents, which have a large proportion of patients brought by 112. Pre-hospital healthcare personel should be educated about the importance of measuring vital signs. In our study, the rate of patients who did not specify any triage code was found to be high. 112 employees should be made aware of this issue. Improper use of ambulance and high discharge status due to this is one of the important problems related to the health system. Providing the necessary coordination and cooperation in the referrals made through 112 will contribute to the correct use of resources by reducing unnecessary referrals.
Açıklama
Anahtar Kelimeler
Ambulans, Acil servis, 112, Ambulance, Emergency service, 112
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Menendi, M. (2022). Üniversite acil servisine 112 ambulans ile başvuran hastaların uygunluk düzeyinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Acil Tıp Anabilim Dalı, Konya.
