Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

The aim of this study was to develop and evaluate a triage method to prevent unnecessary emergency department visits of out-of-hospital poisoned patients. From October 2003 to September 2004, the calls that lay persons gave to the Seoul Emergency Medical Information Center to seek advices on the out-of-hospital poisoned patients were enrolled. We designed a triage protocol that consisted of five factors and applied it to the patients. According to the medical outcomes, we classified the patients into two groups, the toxicity-positive and the toxicity-negative. We arranged the factors on the basis of the priority that was determined in order of the odds ratio of each factor for the toxicity-positive and made a flow chart as a triage method. Then we calculated a sensitivity, specificity, positive predictive value and negative predictive value of the method. We regarded the specificity as the ability of the method and the sensitivity as the safety. A total of 220 patients were enrolled in this study. The method showed a sensitivity, specificity, positive predictive value, and negative predictive value of 99.2%, 53.4%, 76.2%, and 97.9%, respectively. Our triage method prevented 53.4% of the unnecessary emergency department visits of outof-hospital acutely poisoned patients, safely.
Triage/methods/*organization & administration ; Telephone ; Telemedicine/methods/*organization & administration ; Severity of Illness Index ; Sensitivity and Specificity ; Risk Factors ; Risk Assessment/*methods ; Reproducibility of Results ; Prognosis ; Poisoning/*diagnosis/*therapy ; Male ; Korea ; Humans ; Female ; Emergency Medical Services/methods/*organization & administration ; Decision Trees ; *Decision Support Techniques ; Child, Preschool ; Child ; Adult ; Adolescent

OBJECTIVETo study the weak loop in the treatment of children with out-of-hospital cardiac arrest (OHCA) and the treatment strategy for improvement.

METHODData of a total of 133 patients with OHCA who were rescued by Wuxi pre-hospital care center during the 2005 - 2011 were analyzed.

RESULTThe main causes of pediatric OHCA were drowning (52/133) and accidental injury disease (30/133). The cases of OHCA were mainly located in public places (60/133) and the majority occurred in winter and summer. The emergency rescue response time was (13.21 ± 8.09) min, the rate of first witness treatment was 3.91%, intubations was performed in 11.11%, opening of vein access was 23.15% and one case got restoration of spontaneous circulation (ROSC).

CONCLUSIONThe rate of ROSC of pre-hospital cardiac arrest in children was significantly lower than that of hospital cardiac arrest. Preventive interventions on children's accidents and the skills of pre-hospital staff on pediatric advanced life support (PALS) need to be urgently improved.

Advanced Cardiac Life Support ; education ; Cardiopulmonary Resuscitation ; methods ; Chi-Square Distribution ; Child ; Child, Preschool ; China ; epidemiology ; Emergency Medical Services ; methods ; organization & administration ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Out-of-Hospital Cardiac Arrest ; epidemiology ; etiology ; therapy ; Pediatrics ; education ; Retrospective Studies ; Risk Factors ; Survival Rate ; Time Factors ; Treatment Outcome