Clinical Effectiveness of Pre-hospital and In-hospital Optimized Emergency Care Procedures for Patients With Acute Craniocerebral Trauma.

Lili Wang,Rong Wu

doi:10.3389/fsurg.2021.830571

Abstract

Acute craniocerebral injury is a common traumatic disease in clinical practice, characterized by rapid changes in condition and a high rate of death and disability. Early and effective emergency care throughout the pre-hospital and in-hospital period is the key to reducing the rate of death and disability and promoting the recovery of patients. In this study, we conducted an observational study of 130 patients with acute craniocerebral injury admitted between May 2020 and May 2021. Patients were randomly divided into a regular group and an optimization group of 65 patients each, with patients in the regular group receiving the conventional emergency care model and patients in the optimization group receiving the pre-hospital and in-hospital optimal emergency care process for intervention. In this study, we observed and compared the time taken to arrive at the scene, assess the condition, attend to the patient and provide emergency care, the success rate of emergency care within 48 h, the interleukin-6 (IL-6), interleukin-8 (IL-8), and intercellular adhesion molecule-1 (ICAM-1) after admission and 1 day before discharge, the National Institute of Health Stroke Scale (NIHSS) and the Short Form 36-item Health Survey (SF-36) after resuscitation and 1 day before discharge, and the complications of infection, brain herniation, central hyperthermia, and electrolyte disturbances in both groups. We collected and statistically analyzed the recorded data. The results showed that the time taken to arrive at the consultation site, assess the condition, receive the consultation, provide first aid was significantly lower in the optimized group than in the regular group (P < 0.05); the success rate of treatment was significantly higher in the optimized group than in the regular group (P < 0.05). In both groups, IL-6, IL-8, and ICAM-1 decreased on the day before discharge compared with the day of rescue, with the levels of each index lower in the optimization group than in the regular group (P < 0.05); the NIHSS scores decreased and the SF-36 scores increased on the day before discharge compared with the successful rescue in both groups, with the NIHSS scores in the optimization group lower than in the regular group and the SF-36 scores higher than in the control group (P < 0.05). The overall complication rate in the optimization group was significantly lower than that in the regular group (P < 0.05). This shows that optimizing pre-hospital and in-hospital emergency care procedures can significantly shorten the time to emergency care for patients with acute craniocerebral injury, increase the success rate, reduce inflammation, improve neurological function and quality of life, reduce the occurrence of complications, and improve patient prognosis.

Highlights

Acute craniocerebral injuries are mainly caused by traffic accidents, accidental injuries and violence
One hundred and thirty cases of acute craniocerebral injury admitted to our hospital from May 2020 to May 2021 were selected as the study subjects
Pre-hospital and in-hospital optimal care is a combination of pre-hospital emergency care, emergency department resuscitation and in-hospital treatment, and is a nursing procedure developed on the basis of traditional emergency care [26]

Summary

Introduction

Acute craniocerebral injuries are mainly caused by traffic accidents, accidental injuries and violence. Pre-hospital and in-hospital whole process optimization care further evolves on the traditional emergency mode, effectively perfecting the pre-hospital rescue network and trauma rescue mode, and making the whole emergency process procedural and standardized [11, 12]. This model of care has been widely used clinically in the emergency care of acute cerebral infarction [13], acute myocardial infarction [14] and other clinical emergencies, and good results have been achieved. The present study applied the pre-hospital and in-hospital optimal nursing procedure to the emergency treatment of patients with acute craniocerebral injury, and used the emergency-related indexes, the success rate of treatment, the level of inflammatory factors in different periods, the neurological function and quality of life in different periods, and the occurrence of complications as the observation indexes to explore the effect of the pre-hospital and inhospital optimal nursing procedure in the application of acute craniocerebral injury

Methods

Results

Conclusion