Beijing Emergency Medical Center Research Articles

Analysis of family cluster infection with Novel Coronavirus Pneumonia

Objective To explore the regularity and characteristics of the transmission of Novel Coronavirus Pneumonia(NCP) in crowd, for provide a reference for pre-hospital first aid to identify and screen NCP and close contact, at the same time to improve protection awareness and reduce infection rates. Method: Retrospective analysis about the cases of familial aggregation transferred by Beijing Emergency Medical Center between January 20 and February 10, 2020,collect relevant information,including basic information,contact history,symptoms and signs, clinical outcome, etc. Results: The mean incubation period of familial cluster cases was 5.6d,mean time from onset of symptoms to first visit was 1.8d;Among the 5 family cluster cases, 4 had fever,mean body temperature 38oC, the Sp02 averaged 96%; Among the 5 family cluster cases, 4 had cough, 2 had fatigue, and 1 had dyspnea. Conclusion: People are susceptible to infection to NCP,it spreads easily between close contacts, effective isolation is the focus of prevention and control among family members, it is also one of the difficulties of prevention and control. Key words: Novel Coronavirus Pneumonia(NCP); Epidemicology; Clustering cases; Clinical characteristic; Close contacts; Family clusters

Characteristics of COVID-19 Infection In Beijing

Background: Since the first case of a novel coronavirus (COVID-19) infection pneumonia was detected in Wuhan, China, a series of confirmed cases of the COVID-19 were found in Beijing. We analyzed the data of 262 confirmed cases to determine the clinical and epidemiological characteristics of COVID-19 in Beijing. Methods: We collected patients who were transferred by Beijing Emergency Medical Sevice to the designated hospitals. The information on demographic, epidemiological, clinical, laboratory test for the COVID-19 virus, diagnostic classification, cluster case and outcome were obtained. Furthermore we compared the characteristics between severe and common confirmed cases which including mild cases, no-pneumonia cases and asymptomatic cases, and we also compared the features between COVID-19 and 2003 SARS. Findings: By Feb 10, 2020, 262 patients were transferred from the hospitals across Beijing to the designated hospitals for special treatment of the COVID-19 infected by Beijing emergency medical service. Among of 262 patients, 46 (17.6%) were severe cases, 216 (82.4%) were common cases, which including 192 (73.3%) mild cases, 11(4.2%) non-pneumonia cases and 13 (5.0%) asymptomatic cases respectively. The median age of patients was 47.5 years old and 48.5% were male. 192 (73.3%) patients were residents of Beijing, 50 (26.0%) of which had been to Wuhan, 116 (60.4%) had close contact with confirmed cases, 21 (10.9%) had no contact history. The most common symptoms at the onset of illness were fever (82.1% ), cough (45.8%), fatigue (26.3%), dyspnea (6.9%) and headache (6.5%). The median incubation period was 6.7 days, the interval time from between illness onset and seeing a doctor was 4.5 days. As of Feb 10, 17.2% patients have discharged and 81.7% patients remain in hospital in our study, the fatality of COVID-19 infection in Beijing was 0.9%. Interpretation: On the basis of this study, we provided the ratio of the COVID-19 infection on the severe cases to the mild, asymptomatic and non-pneumonia cases in Beijing. Population was generally susceptible, and with a relatively low fatality rate. The measures to prevent transmission was very successful at early stage, the next steps on the COVID-19 infection should be focused on early isolation of patients and quarantine for close contacts in families and communities in Beijing. Funding Statement: This study was supported by the Beijing Municipal Science and Technology Project (Z191100004419003) and the National Science and Technology Fundamental Resources Investigation Project (2018FY100600). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: The study was approved by Ethics Committee of Beijing Emergency Medical Center (No.2020- 01) and the written informed consent was waived because of the retrospective nature of the study and belongs to emergency medical service.

Effects of Shenfu injection on survival and neurological outcome after out-of-hospital cardiac arrest: A randomised controlled trial

AimWe aimed to assess the effects of Shenfu injection (SFI) in combination with epinephrine during cardiac arrest on survival and neurological outcome after out-of-hospital cardiac arrest (OHCA). MethodsIn this randomised, assessor-blind controlled trial, Utstein-style data were collected from 1233 OHCA patients treated at the Beijing Emergency Medical Center between January 2013 and June 2016. The patients were randomised into either a treatment group that received a combination of SFI and standard treatment with epinephrine or a control group that received standard treatment with epinephrine alone. The primary outcome was survival to hospital admission. The secondary outcomes were return of spontaneous circulation (ROSC), survival to hospital discharge, favourable neurological outcome at discharge, survival to one year, and favourable neurological outcome at one-year survival. ResultsIn both groups, the survival to hospital admission, ROSC, survival to hospital discharge, and one-year survival rate after discharge from the hospital did not differ significantly. However, SFI achieved favourable neurological outcome at discharge in comparison with the standard treatment with an odds ratio (OR) of 2.72 at a 95% confidence interval (CI; 1.00–8.53). Meanwhile, unlike with epinephrine alone, the combination of SFI and epinephrine achieved a better cerebral performance category (CPC) score (1–2) after one-year survival (OR: 5.08, 95% CI: 1.07–47.80). ConclusionThe combination of SFI and epinephrine had favourable neurological outcomes after OHCA compared with those with epinephrine alone, whereas the survival to admission was not significantly altered.

Traffic Congestion, Ambient Air Pollution, and Health: Evidence from Driving Restrictions in Beijing

AbstractVehicles have recently overtaken coal to become the largest source of air pollution in urban China. Research on mobile sources of pollution has foundered due both to inaccessibility of Chinese data on health outcomes and strong identifying assumptions. To address these, we collect daily ambulance call data from the Beijing Emergency Medical Center and combine them with an idiosyncratic feature of a driving restriction policy in Beijing that references the last digit of vehicles’ license plate numbers. Because the number 4 is considered unlucky by many in China, it tends to be avoided on license plates. As a result, days on which the policy restricts license plates ending in 4 unintentionally allow more vehicles in Beijing. Leveraging this variation, we find that traffic congestion is indeed 22% higher on days banning 4 and that 24-hour average concentration of NO2 is 12% higher. Correspondingly, these short-term increases in pollution increase ambulance calls by 12% and 3% for fever and heart-rela...

Pre-hospital and in-hospital first aid programs and specifications for spine and spinal cord injury in Beijing, China: study protocol for a prospective, multicenter, nonrandomized controlled trial

Background: The optimal time to rescue spinal cord function after spinal cord injury is within 24 hours, especially within 3 to 8 hours, after the injury. Timely and proper pre-hospital first aid, hospital admission, patient assessment, and surgery are essential for the rescue of spinal cord function. A sound and rapid treatment system is the basis for improving the level of injury treatment and recovery of spinal cord function. China currently lacks a systematic and standardized treatment system. Methods/Design: We herein propose our study protocol for a prospective, multicenter, nonrandomized controlled trial. We will recruit 200 patients with acute spinal cord injury undergoing pre-hospital treatment at Beijing Emergency Medical Center and Beijing Red Cross Emergency Rescue Center and receiving in-hospital treatment at Peking University People's Hospital, Peking University Third Hospital, Beijing Friendship Hospital Affiliated to Capital Medical University, Chaoyang Hospital Affiliated to Capital Medical University, and Chinese PLA General Hospital, China. This study will comprise two parts: (1) establishment of a database of patients with spinal cord injury in the Beijing area; and (2) formulation of the pre-hospital and in-hospital process and establishment of a standardized treatment protocol for acute spinal cord injury. The primary outcome will be the American Spinal Injury Association impairment scale score for spinal nerve function. The secondary outcomes will be spinal X-ray, three-dimensional computed tomography, and magnetic resonance imaging findings and the incidence of complications due to improper pre-hospital and in-hospital treatment of acute spinal cord injury. Discussion: The aims of this study are as follows: (1) We will establish a spine and spinal cord injury treatment database in the Beijing area. (2) We will assess the complete pre-hospital and in-hospital evaluation of spine and spinal cord injury, develop and optimize first aid procedures, and create a pre-hospital and in-hospital standardized training program for the treatment of spine and spinal cord injury. (3) We will build a pre-hospital and in-hospital first aid “green channel” for acute spine and spinal cord injury after completion of the study. (4) We will develop first aid guidelines and establish an evaluation and treatment system for early surgery to save spinal cord function and reduce the degree of disability to the greatest extent as possible. (5) We anticipate that our results will be used in expert consensuses on acute spinal cord injury and that “green channel” patterns will be promoted in hospitals in Beijing and other cities of China to improve the level of first aid treatment of acute spine and spinal cord injury in Chinese cities and reduce the occurrence of secondary injury and severe dysfunction due to improper treatment. This trial will begin in May 2017. Patient recruitment will be finished in August 2019. Analysis of all data and results will be completed in December 2020. Trial registration: ClinicalTrials.gov identifier: NCT03103516. Ethics: All protocols will be in accordance with Ethical Principles for Medical Research Involving Human Subjects in the Declaration of Helsinki (2013), formulated by the World Medical Association. The study protocol has been approved by the Medical Ethics Committee of Peking University People's Hospital, China (approval number: 2016PHB136-01). Informed consent: Written informed consent will be provided by legal representative of participants.

Changes and trends of pre-hospital emergency disease spectrum in Beijing in the past decade (from 2003 to 2012)

Backgrounds: Pre-hospital emergency call is a crucial index to indicate emergency disease spectrum. For Beijing, which has changed greatly in economy and population, analyzing the trend of the emergency disease spectrum can greatly contribute to formulate the pre-hospital emergency planning. Methods: In this 10-year retrospective study, pre-hospital emergency records of Beijing Emergency Medical Center from 2003 to 2012 were collected. Medical Priority Dispatch System was used to classify the call demands. Linear regression models were constructed to examine the changing trends. Results: 2,410,575 cases were collected, and 2,278,415 of them were analyzed in this study. The results showed that: 1. In the past decade, the number of pre-hospital emergency call demands soared from 150,656 to 309,297 (204.6%, 2012/ 2003, p<0.001). 2. The top five call demands based on the rank of proportion were trauma related demands(25.4%, including falls（5.0%）, traffic/ transportation incidents(7.2%) and traumatic injuries(13.1%)), sick person(17.7%), heart problems(11.4%), unconscious/fainting（10.0%） and breathing problems（8.1%）Also, they were the top five fastest growing call demands. Conclusion: Compared with the growth of population (145.4%, 2012/2003), pre-hospital emergency calls increased much more, which shows a growing desire on ambulance service. Different from developed countries, the proportion of trauma related cases was constantly in the top rank and continuously increasing, much higher than that in San Francisco (15.7%), which could be resulted from accelerated city construction and rapid augment of vehicle quantity(244.8%, 2012/ 2003). Based on the changes and trends of pre-hospital emergency disease spectrum, it is encouraged to provide specific training program for emergency medical service staff and improve related medical devices. Note: Beijing emergency medical center is the only pre-hospital emergency system of Beijing government

Changes and trends of pre-hospital emergency disease spectrum in Beijing in 2003–12: a retrospective study

BackgroundPre-hospital emergency call is a crucial indicator of emergency disease spectrum. Since Beijing has changed substantially in economy and population, analysis of the trend of the emergency disease spectrum can greatly contribute to pre-hospital emergency planning. MethodsIn this 10-year retrospective study, pre-hospital emergency records of Beijing Emergency Medical Center, the only pre-hospital emergency system of Beijing Government, in 2003–12 were collected. Medical Priority Dispatch System was used to classify the call demands. Linear regression models were used to examine the trends. This study was exempt from ethical approval. Findings2 410 575 cases were collected. Non-pre-hospital requests, which were identified when the crew arrived, were excluded. Uncompleted and unidentified cases were further excluded, and 2 278 415 cases (94·5%) were included in the analysis. The number of pre-hospital emergency call demands soared from 150 656 in 2003 to 309 297 in 2012 (205·3%; p=0·158). The top five call demands throughout the decade were trauma-related demands (25·4%, including falls [5·0%], traffic or transportation incidents [7·2%], and traumatic injuries [13·1%]), general injuries (17·7%), heart problems (11·4%), unconsciousness or fainting (10·0%), and breathing problems (8·1%). These were also the top five fastest growing call demands. InterpretationCompared with the population growth in 2003–12 (145·4%), pre-hospital emergency calls increased much more, which shows a growing demand for ambulance service. By contrast with cities in developed countries, the proportion of trauma-related cases was constantly the highest among call demands, much higher than that in San Francisco (15·7%) in 2009, and is continuously increasing. This could be a result of accelerated city construction and rapid rise in vehicle quantity (244·8%). On the basis of the changes and trends of pre-hospital emergency disease spectrum, specific training programmes for emergency medical service staff and improvement in related medical devices are recommended. FundingResearch Special Fund for Public Welfare Industry of Health from the National Health and Family Planning Commission of China.

Emergency medical service for the Beijing Olympic Games and its outcome

Emergency Medical Service (EMS) of Beijing Olympic Games needs to cover not only all the venues of the Olympic and Paralympic Games, but also emergency medical service for citizens at large and other emergency events. To this end, Beijing Emergency Medical Center made efficient preparations for the Olympic Games, namely upgraded dispatch system, first-aid stations, ambulances and equipment, and volunteer recruitment among others. Thanks to such efforts made, the EMS successfully served the Beijing Olympic Games and citizens at large. Furthermore, the Beijing Olympic Games promoted the development of the Beijing EMS system. Key words: Olympic Games; Paralympic Games; Emergency Medical Service (EMS); Beijing

Beijing's Drive to Modernize Its Emergency Medical Service

Abstract The Beijing Emergency Medical Center, a Sino-Italian joint-efforts will be ready to open late this year (1988). Considered to be the first and best-equipped emergency service in China, the center will serve over ten million Beijing residents. In the next dozen years, 20 sub-centers will be set up as part of a renovation program of general hospitals and district-level first-aid stations.