How to improve the pre-hospital emergency medical care capacity

Abstract The article illustrates the growth momentum of emergency medical care and people's strong demand for emergency medical care through the figures of emergency vehicles and high morbidity species in recent years, but what is incongruous with this strong demand is the lagging development of pre-hospital emergency medical care in China, which has a big gap with the current development of the society, seriously restricting the improvement of pre-hospital emergency medical care capacity and impeding the development of emergency medical care career. The article from the professional team instability factors; pre-hospital emergency scale and capacity issues; pre-hospital emergency laws and regulations, industry standards are not perfect; social first aid training is deficient in four aspects of the constraints on pre-hospital emergency medical capacity to improve the difficulties and problems, and puts forward the corresponding ideas for improvement for everyone to discuss.

Keywords: pre-hospital first aid

Pre-hospital first aid refers to the emergency medical care of critically ill and injured patients before they enter the emergency room of the hospital, at the scene of the incident and on the way of transfer. A western first aid expert vogt once said that "for the average citizen, the biggest threat is not a fire at home, nor is it the criminals on the road, but not in a few minutes of life and death can not get emergency medical care". This shows the importance of emergency medical care in protecting people's lives and health.

With the development of society, China has entered the stage of population aging, the increase of all kinds of sudden illnesses, all kinds of accidents and the surge in the frequency of traffic accidents, the demand for emergency medical care has shown an unprecedented growth momentum. From the Chifeng Emergency Medical Center, in 2004, 5,384 emergency vehicle trips and 3,511 emergency patient trips were made; in 2005, 6,237 emergency vehicle trips and 4,547 emergency patient trips were made, an increase of 15.8% and 29.5% respectively compared with 2004; in 2006, 6,933 emergency vehicle trips and 4,737 emergency patient trips were made, an increase of 11.15% and 4.11% respectively compared with 2005; and in 2006, 6,933 emergency vehicle trips and 4,737 emergency patient trips were made. In 2006, 6,933 emergency vehicles and 4,737 emergency patients were dispatched, representing an increase of 11.15% and 4.11% respectively over 2005. Statistical 2004-2006 Chifeng Emergency Center, the first four types of diseases in order: traffic accidents caused by injury, acute cerebrovascular disease, trauma, heart disease, etc., heart disease in autumn and winter relative increase, trauma is relatively declining, of which car accidents, cardio-cerebral and cerebral vascular diseases, trauma accounted for pre-hospital emergency treatment of the total amount of 60% or so, has become the main pre-hospital emergency medical care of the treatment of illnesses. In the pre-hospital emergency services in our region, the elderly over 60 years of age accounted for 48% of the emergency services. From a national perspective, the demand for pre-hospital emergency care is also very large. However, with this strong demand is not coordinated with the current development of China's pre-hospital emergency medical lag, and the current social development there is a large gap, it is difficult to adapt to the needs of the community and the people, such as not being able to properly and effectively solve the problem, it will seriously constrain the pre-hospital emergency medical capacity to improve, hindering the development of pre-hospital emergency medical career.

The main difficulties and problems:

1, the professional team is not stable, the difficulty of talent training, the level of specialization is not high. Pre-hospital work is different from the hospital, has its own particularities. First of all, there is no restrictive disease classification of the service object, there is a diagnosis must be out is the principle. Secondly, the place of practice in the patient's home or public **** place, the lack of necessary protective medical measures. Thirdly, the work is not regular and difficult to plan, both mental labor and more physical labor. In addition to the wide range of specialties, risk factors, low welfare benefits, not respected and other factors, so that the formal institutions of undergraduate education and undergraduate degree or above, almost no one is willing to work in the emergency center, even if the college education of the doctor is not at ease in the center of the work, resulting in difficulties in the establishment of long-term stability of the professional pre-hospital emergency medical team, especially the doctor's team, coupled with the historical reasons for the level of education of the emergency personnel, the lack of systematic clinical training, the lack of medical emergency personnel, and the lack of necessary protection of medical measures. Low, lack of systematic clinical training, business level is poor, is an important factor restricting the development of pre-hospital emergency professional.

2. There is a big difference between the scale and capacity of prehospital emergency care and the social demand. According to the standards issued by the Ministry of Health, every 50,000 people in the city need to be equipped with an ambulance, each ambulance with doctors, nurses, drivers, stretcher bearers, each region according to the size of the city against this standard is difficult to meet, the people want to emergency vehicles difficult and back to the car phenomenon prevails. Now there is a general shortage of staffing, the number of equipment is not enough, less guardianship ambulance, insufficient funding, so that the emergency work capacity to keep up with the demand, resulting in China's pre-hospital emergency medical service quality is low.

3, the laws and regulations are not perfect, the lack of national authoritative industry unified standards. Developed countries in the middle and late last century has generally realized the emergency medical legislation, while China in this field is relatively lagging behind, so far in the emergency medical legislation is almost blank. At present, China's pre-hospital emergency medical care lacks scientific norms and unified industry standards, the access system of practitioners, practitioners' qualification certification and training, standardization of the rescue process, the construction of the 120 command center, the division of responsibility for accidents and so on have to be standardized and normalized. Until now, many cities still exist in each hospital to set up their own emergency telephone, interfere with the full and reasonable use of the 120 emergency telephone.

4, social first aid training is lacking, resulting in social awareness of pre-hospital emergency. At present, social training has been carried out in large and medium-sized cities in China, but most areas due to various conditions are not carried out, the people of the basic first aid knowledge is not clear, can not be in the first aid incident occurs on their own or around the implementation of the first aid: some people are not clear about the emergency telephone number, or in the telephone number dialed after not be able to communicate effectively, thus delaying the effective implementation of emergency medical care. The people are not aware of the emergency help number or cannot communicate effectively after dialing the number, thus delaying the effective implementation of emergency care. Due to the error of consciousness, the quality of the lower, repeated occurrence of the phenomenon of disrespect for people's lives, playing harassment calls to occupy the line, cheating cars, and ambulance road and so on.

In summary, China's pre-hospital emergency medical care there are many problems, these problems are the main bottleneck restricting the improvement of emergency medical care capacity, facing urgent market demand must be resolved, otherwise it will seriously affect the normal operation of emergency medical institutions. How to solve these problems, put forward some ideas for improvement as follows for discussion.

1, the government attaches importance to and increase investment is to solve the problem of the premise

Pre-hospital emergency medical work to assume some of the functions of the government, as an important part of the emergency security system, in emergencies, all kinds of major accidents, large-scale activities in the medical security and daily emergency medical assistance plays a major role, the government should be from the height of the strategic design of China's pre-hospital emergency medical career development planning, increase financial investment and the daily emergency medical assistance, the government should be from the height of the strategy. The government should design China's pre-hospital emergency care business from a strategic height to the development planning, increase financial investment and in various policies to be appropriate tilt, to ensure that the necessary conditions for its development.

2, strengthen the construction of laws and regulations to promote the standardization of pre-hospital emergency

The construction of laws and regulations is an effective means of regulating pre-hospital emergency medical care, through legislation, standardize the management procedures of medical emergency; to solve the problems in the emergency medical system; to make clear that the departments at all levels, medical institutions and citizens in the process of first aid rights and obligations; to protect the legitimate rights and interests of the people in the form of law, first aid institutions and first aid personnel and personal safety. The lawful rights and interests and personal safety of the people and first-aid institutions and first-aid personnel are safeguarded in the form of law, so as to make the medical first-aid truly enter the legalized and standardized track, and keep pace with the development of the society. The problems of the emergency medical care industry, the establishment of industry access system is the fundamental measures to clear up the root cause, to all will be involved in the emergency medical care market medical institutions practitioners, rescue technology, equipment and equipment to establish a legal threshold.

3, improve the practice environment, improve the social status

Without specialization, there is no high level. To change the current situation of pre-hospital emergency care must take targeted and effective measures to improve the social status of pre-hospital emergency personnel through a series of measures to improve the pre-hospital emergency personnel practice environment, to create superior working conditions, mobilize the enthusiasm of talented people, creativity, to give them a space to play their talents. Improve the treatment of first aid personnel, set the title of first aid personnel to promote their counterparts in the profession, so that their identity has a clear positioning, so as to lay the foundation for the stabilization of this team.

4, strengthen the scientific management, improve the emergency capacity

Scientific management needs from the organization, human resources, workflow, resource allocation and other aspects of the pre-hospital emergency work to carry out a comprehensive assessment and improvement. First of all, the system should be adapted to the needs of emergency work to minimize the command level and intermediate links, everything should be from the practical point of view, focusing on relevance and practicality. Secondly, the post setting and staffing of pre-hospital emergency medical care and operational training should be reasonably planned. In the arrangement of ambulance personnel can also be based on specific requirements, configuration of different professions or different levels of ambulance personnel must be standardized in the number of people equipped. In the workflow to implement the optimization, the most convenient process way, make it fast and effective. On this basis, the configuration of the ambulance, auxiliary ambulance equipment and the number of material needs, space arrangement for rational planning, in order to facilitate the use of ambulance scene.

5, to carry out a wide range of social first aid training

Extensive social training so that the effective implementation of pre-hospital emergency basis, only the whole society to pay attention to the cause of pre-hospital emergency, and understand the basic knowledge of first aid, master the basic first aid skills, in order to improve the whole society's awareness of first aid and ambulance level. Only in this way, 120 harassment calls, invalid calls, wrong first aid treatment and with the ambulance to steal the road and so on can be greatly reduced.

The difficulties and problems of pre-hospital emergency care are common phenomena, and we must find out the causes, analyze them scientifically, and solve them from the root and the fundamental in accordance with the principle of reasonableness and possibility, so as to make the pre-hospital emergency care cause of our country develop in a healthy and orderly way.

References:

1, Wu Xiukun pre-hospital emergency difficulties and problems

2, Wu Xiukun Health News emergency salon guest speaker

3, Su Qiang, China's pre-hospital emergency care problems faced by the cause of the problem and its solution strategy

4, Guo Rongfeng from the practical point of view of the comprehensive thinking of the operation mode of 120 emergency centers to ensure that the emergency centers Medical treatment capacity

5, Zhang Ping, the difficult problems in the construction of first aid centers