Epidemiological Study Of Pre-hospital First Aid In Lanzhou

Objectives To reveal the epidemiological features on pre-hospital first aid patients in Lanzhou city and provide objective suggestions to pre-hospital first aid based on epidemiological survey and analysis and further analysis to focus groups (such as trauma patients, elderly patients and dead cases).Methods This study’s objects were randomly selected in33% proportion from pre-hospital first aid patients from120emergency services in the Emergency Medical Rescue Center of Gansu province during1st July,2010to30th June,2011. We included9530pre-hospital first aid patients finally after excluded some cases due to some reasons as ambulance withdraw, patients left before ambulance and treatment rejection.9530included pre-hospital first aid patients’ structural variables such as age, gender, and diagnosis results were retrospective analyzed. Questionnaires were filled in by investigators after unified training and then verified by specific researchers. To control bias during information entry process, we selected10%data randomly to check. Diseases collation, analysis and classification were referring to related reference and International Classification of Diseases (ICD-10). Confirmed diagnosis was based on the first-listed diagnoses, which were initial impressions of emergency medical technicians. With regards to uncertain cases, we completed data by follow-up calling visits and looking up medical records. To avoid reduplication of diseases classification, some nervous system disease resulted in traffic accidents or fighting directly were trauma category. For cases less than1%didn’t classify and analyze separately. Additionally, some unknown symptoms and cases were classified to reasons unknown classes. Structural and performance variables were statistics analyzed on excel and SPSS software were conducted to test whether there was significant difference (P value<0.05) in enumeration data, tables and charts were used to describe the distribution. Results (1) Trauma (30.05%) had the highest morbidity rate of Pre-hospital first aid patients in Lanzhou city, then the higher were nervous system disease and cardiovascular disease. Male patients were more than females totally, which males accounted for61.13%. In trauma cases, female were2times more and significantly higher than women.(2)In the patients age structures, most were middle-aged and elderly, and the elder aged above60were36.58%.(3)Pre-hospital first aid occurred during at14:00to22:00mainly. Poisoned patients, especially acute alcohol intoxication accounted for73.20%which emergency happened at night.(4)Traffic accidents (56.35%) was the main reason for trauma, other reasons were fell wounded and fighting injuries.(5)In elderly cases, nervous system diseases were the main reason for pre-hospital emergency, followed by cardiovascular system disease and trauma. Elderly patients’time distribution was curved into a hump shape, which reached the first peak at16:00～17:00(mainly for trauma), and fell slightly during18:00-20:00and then peaked again22:00～24:00.(6)Among524acute dead cases,335female and189male which ratio was1.77:1. Regarding to age distribution, the highest proportion were60and above group which accounted for20.42%. There was rising trends in time periods6:00-8:00and12:00～14:00. Cardiovascular system diseases were the first death cause in Lanzhou, followed by nerve system disease, trauma, and respiratory diseases.(7)Sudden cardiac death was the main reason of death in cardiovascular system diseases. Elderly patients were the target population on diseases in circulatory system, nervous system and respiratory system while trauma death is mainly young adults.Conclusions Pre-hospital first aid patients should be classified by diseases categories, ages or time distribution, so they can be arranged scientific and reasonable. For target patients’getting timely treatment and nursing care, such as trauma, the elderly and death cases, pre-hospital first aid organizations should organize personnel training regularly, provide pre-hospital first aid based on their epidemiological features, reduce the morbidity and mortality of first aid on pre-hospital, and ensure the safety of people’s lives eventually.