基于北京市120院前医疗急救道路交通伤害相关资料,分析道路交通伤害的区域差异,指出道路交通伤害具有明显的地域分布,存在中度以上的空间聚集,对于指导区域内院前医疗急救资源配置和"绿色通道"建立具有一定参考意义.

Objective:To study the average pre-hospital emergency response time in Yanqing District, and to understand the level of pre-hospital emergency system in Yanqing District.Methods:Based on the 120 dispatch information database of Beijing Emergency Medical Center, a retrospective analysis was conducted on 27, 621 first-aid cases in Yanqing District from 2015 to 2020, which met the inclusion and exclusion criteria.Results:The average pre-hospital emergency response time in Yanqing District from 2015 to 2020 were 16.45(18.44) min, 16.02(14.76) min, 15.91(13.12) min, 16.29(13.22) min, 14.51(11.18) min and 13.23(10.19) min, respectively; in 2020, the average response time of pre-hospital emergency was less than that of other years, and there were significant differences. The average percentile of pre-hospital emergency response time in each year was shortened, and the proportion in 12 minutes was increased obviously.Conclusions:From 2015 to 2020, the average pre-hospital emergency response time in Yanqing District has significantly been shortened, and the construction of emergency medical service system achieves good results.To ensure the 2022 Winter Olympic Games, the emergency medical service system should be further improved.

2003年以来,在总结SARS疫情防控经验教训的基础上,我国逐步加强了以"一案三制"为核心内容的应急管理体系建设,颁布了《中华人民共和国突发事件应对法》《突发公共卫生事件应急条例》等一系列相关法律法规,制定了《国家突发公共事件总体应急预案》《国家突发公共卫生事件应急预案》《国家突发公共事件医疗卫生救援应急预案》等一整套应急预案,建立了"统一领导、综合协调、分类管理、分级负责、属地管理"的应急管理体制,根据我国的实际工作经验,借鉴国际卫生应急成功做法,形成了卫生应急事件处置、风险评估、协调联动、国际合作等一系列卫生应急工作机制,提高了处置突发事件的能力,对全国医疗救治体系进行了规划建设.

目的 通过对北京120院前转运5338例疫情相关任务的出车数据进行研究,探讨120传染病防控转运系统在城市突发公共卫生事件疫情防控中的作用与特点.方法 对2020年1月20日0时至3月15日0时期间北京120急救网络院前转运新型冠状病毒肺炎(COVID-19)疫情相关任务的出车数据进行统计和回顾性分析.结果 根据类别数量和占比[n(％)]统计,转运密切接触者2925次(54.80)、口岸排查1196次(22.41)、来自武汉537次(10.06)、确诊病例338次(6.33)、疑似病例260次(4.87)、治愈82次(1.54),占同期总任务数的8.23％.不同部门执行任务数量比例为急救中心直属分中心167次(3.13),防控转运组1926次(36.08),网络分中心3245次(60.79).平均转运时间为51.34分钟.结论 120传染病防控转运系统在控制传染源、切断传播途径和保护易感人群的整体防疫工作中达到了院前管理的专业目标,起到关键作用;合理的院前急救体系建设是系统有效运行的基础保障;完善工作流程,对关键环节统筹管理,可提高系统运行效率.

应急演练是训练、检验、评估、改进应急能力及应急管理水平的核心手段[1],也是应急准备的重要内容之一,演练质量直接关系到突发事件发生后的应对处置效果[2].2019北京世界园艺博览会(简称“北京世园会”)是经国际园艺生产者协会批准,由中国政府主办、北京市承办的最高级别的世界园艺博览会,自2019年4月28日开幕至2019年10月9日闭幕,为期162天,共接待各类入园参观人数934万人次,会期共举办3 284场文化活动[3].大型公众集会的一个重要危险因素是踩踏事故[4-5].为做好北京世园会期间医疗应急保障工作,确保园区内发生突发事件时,紧急医疗救援能够做到迅速反应、及时到位、有效处置,北京急救中心与北京市延庆区卫生健康委联合北京世园局于开幕前组织了2019北京世园会模拟踩踏事故紧急医疗救援应急演练.笔者对此次演练进行了回顾分析,现报道如下.

北京作为全国政治中心、文化中心、国际交往中心和科技创新中心,召开具有国际影响力的重要会议日益增多,举办各类大型活动、会议、体育赛事、重要展会、文化交流也日益频繁,北京急救中心作为北京市院前急救的重要力量,承担着各类大型活动和重要会议的医疗保障任务.现通过北京急救中心2015年1月—2018年12月完成的3132次大型活动院前急救保障任务总结和分析,分享工作中的经验,为今后院前急救在医疗保障中提供更好医疗服务打下基础.

目的从医院视角探讨突发事件应急救治过程中存在的问题已整体化管理的建议.方法通过对首都医科大学宣武医院2015年1月—2019年1月期间急诊应对突发事件应急救治情况进行回顾性分析,对存在的问题进行分析与整改,包括医院自身的改进流程,修订预案,调整急诊创伤接诊模式,信息化建设以及对青年医生应急能力的培养等,平战结合反复演练,以问题为导向持续改进,医院参与区域协作方面的工作,政府部门针对突发事件整体化管理工作的改进,结果与2015年相比,2019年医院应对突发事件时的流程更加顺畅,能够体现整体化管理,仍有一定的改进空间.结论从医院的视角对比改进前后的变化,进一步探讨突发事件应急救治的整体化管理思路.

医疗保障工作是各类重要会议组织工作中必不可少的一部分.近些年,北京急救中心多次执行各类重要会议医疗保障任务,但远赴杭州异地参与重要会议医疗保障尚属首次,共派出30辆救护车、104人组成的峰会医疗保障队,圆满完成此次医疗保障任务.本研究介绍了赴杭州与杭州急救中心共同执行2016中国杭州国际峰会医疗保障任务的基本情况,包括组织管理、具体实施、工作流程、注意事项等,通过执行此次异地医疗保障任务,加强了与当地同仁的沟通交流、积累了异地医疗保障经验、锻炼了医疗保障队伍、完善了工作制度、细化了工作流程,为探索建立异地医疗保障工作管理模式积累了经验.

Objective To summarize the Pre-hospital emergency quality management of 120 affiliated with the district and county in Beijing. Methods A retrospective analysis was conducted on the workload of Pre-hospital emergency, the rate of complaint, the 90-minute timeout rate of the mission and the 2-minute timeout rate of the start driving, during the period of 2012-2014. Results The 90-minute timeout rate of the mission and the 2-minute timeout rate of the start driving were markedly reduced,the workload of 120 affiliated with the district and county in Beijing increased year by year, the rate of complaint declined year by year. Conclusion The gradual improvement of the organization and system is an important guarantee for the quality management. The pre-hospital emergency quality management of 120 affiliated with the district and county in Beijing has obvious effect.

Acute myocardial infarction (AMI) still seriously threatens the health of the people in our country. The situation is even more severe in the vast urban and rural areas in China. Timely treatment of AMI patients to reduce mortality and protect heart function is very important. Prehospital thrombolysis treatment has great significance in urban and rural areas outside the big cities. To this end, the Chinese Medical Doctor Association's chest pain professional committee and the Chinese Medical Rescue Association's Cardiovascular Emergency Sub-Commission organized relevant experts to formulate this consensus, aiming to help prehospital medical emergency personnel select the best treatment strategies for patients with AMI. However, the final decision on a specific patient should be made by the prehospital emergency personnel together with the patients and their family members.

Objective To provide reference for the medical priority dispatching of pre-hospital emergency in Beijing. Methods On the basis of domestic and foreign research, this paper analyzes the necessity of the pre-hospital emergency medical priority dispatching in Beijing, and analyzes its feasibility by SWOT analysis. Results The demand for pre-hospital emergency in Beijing is constantly increasing, the resource allocation is insufficient and there is waste. There are strengths and opportunities to carry out the medical priority dispatching, and there are also weaknesses and threats. Conclusion It is necessary and feasible to carry out the medical priority dispatching of pre-hospital emergency in Beijing, and it should seize the opportunity, make overall plans and systematically promote the work.

Objective To analyze the characteristics of emergency medical rescue mission in Beijing 120, and provide support to strengthen the capacity building of emergency medical rescue. Methods A retrospective statistical analysis was made on the number, regions and time distribution of emergency medical rescue missions in Beijing 120 during the period from 2010 to 2015. Results In the past six years, the number of emergency medical rescue missions in Beijing has increased by an average of 42.26％,with traffic accidents accounting for 36.66％. The number of emergency medical rescue mission in Chaoyang,Haidian and Fengtai district was the top three in the 16 districts, accounting for 24.06％, 11.23％ and 11.22％ of the city's total. In the 12 months, the number of emergencies was the fewest in February and the most in August. In 24 hours, the total number of emergencies is higher than that in the night, at least from 4:00~6: 00,and most at 8: 00～10: 00. Conclusion The number of emergency medical rescue missions and the number of casualties in the emergency medical rescue in Beijing 120 are obviously increasing, with regional and temporal distribution characteristics, and traffic accidents are the main types.

目的:调查分析北京市120急救网络院前急救人员的流失情况,为稳定院前急救网络急救队伍提供理论依据.方法:采用自行设计的调查问卷,对2012~2015年期间北京市急救网络96个急救分中心(站)院前急救人员流失情况进行普查.结果:3年时间,急救人员流失共369人,其中急救医生187人、急救护士116人、救护车司机50人、担架员10人、调度员6人;流失的主要原因为薪资待遇低,院前急救工作风险高、单位无法解决个人编制问题、缺少院前急救独立的职称评定体系、职业发展受限,院前急救工作强度大、体力消耗大、无法受到应有的尊重.结论:院前急救网络急救人员流失严重,影响了院前急救队伍的稳定性,应采取增加财政经费投入,建立合理薪酬待遇等措施来提高北京市院前急救网络院前急救人员的稳定性.

地理信息系统是将普通信息管理系统与矢量图形结合在一起，基于空间信息进行各种属性数据的统计、分析和处理并提供决策支持的系统。本文结合地理信息系统的特点和院前急救的需求，将地理信息系统（GIS）引入院前急救，从地理信息系统的定义、内容、功能等着手，对GIS在急救站展示、呼叫信息分布、院前急救网络规划、最佳救援路径分析、移动GIS、突发事件应急处置等方面的具体应用进行探索，并对GIS应用于院前急救提出一些思考。

Objective To analyze the gender,age and disease classification discipline of Beijing 120 adult patients with pre-hospital care to improve the pre-hospital emergency work.Methods A retrospective analysis was performed,based on Beijing Emergency Center Scheduling Information Database,on Beijing 120 adult patients with pre-hospital care in 2010.Results In the patients of Beijing 120 adult patients with pre-hospital care in 2010,men: women was 1.5∶ 1.Total number of the patients 18 ~ 44 year,most(29.33%),90 over the age of patients was the least(1.32%),45 ~ 89 year increased with age.Top five diseases were respectively trauma,cardiovascular disease,cerebrovascular disease,digestive system disease,re-spiratory disease,the largest group of trauma were patients 18 ~ 44,most patients at the age of 75 ~ 89 in other groups.Conclu-sion Beijing 120 adult patients with pre-hospital care are of gender,age and disease features.Targeted to carry out the related work,to build the whole society to participate in the pre-hospital first aid system can make patients get better pre-hospital e-mergency services.

Objective Through analyzing the epidemiology characteristics of pre-hospital traffic injuries in Beijing,to provide reference for preventing and managing traffic injuries.Methods The data from Jan.to Dec.2010 from Beijing Emergency Medical Center dispatch information database were collected,and facors involving age,occurrence time,damage degree and injury site,etc.were analyzed retrospectively.Results Traffic injury mainly occurred in the 14 to 59 age group(79.5%).The 3rd and 4th season were the peak seasons in a year(64%).Most injury happened at 8:00-22:00 in a day.Brain and limb were common sites of injury.Brain trauma and multiple injuries were the most common causes of death in traffic injuries.Conclusion Through epidemiological analysis of traffic injuries,we can take more effective measures to reduce traffic injury incidence,standarize on-scene treatment,so as to improve the capability of pre-hospital care.

Objective To analyze the region and time distribution of 120 EMSS demand in Beijing to optimize pre-hospital emergency resources.Methods A retrospective analysis was performed,based on Beijing Emergency Center Scheduling Information Database,on 120 emergency demand and unmet demand in Beijing in 2010.Results The 6 main regions of Beijing demanding for 120 emergency were,from most to fewest,Chaoyang,Haidian,Fengtai,Xicheng,Dongcheng and Shijingshan.The demands were fewest at 4:00~5:00 o′clock,then increased gradually,reached the peak at 9:00~10:00 o′clock,and a slow downward trend presented,thereinto the second peak appeared in Dongcheng,Xicheng and Shijingshan at 20:00~21:00o′clock,and in Chaoyang,Haidian,Fengtai at 21:00~22:00 o′clock.The unmet demands of 6 regions were the fewest at o′clock,then increased gradually,reached the peak at 4:00~6:00 o′clock,and then went downward,reached the second peak at o′clock.The unmet demands were the most in Chaoyang,the fewest in Shijingshan.Conclusion Demands for 120 pre-hospital emergency are of region and time distribution features.Further regulation and improvement of emergency resourses allocation is conducive to raising the efficiency of pre-hospital emergency to meet better the demands of residents.

目的 对北京120急救呼叫电话部分信息进行分析,为科学合理配置急救资源提供依据.方法 以北京急救中心调度信息数据库为基础,对北京市2010年1月1日～12月31日间120急救呼叫电话量、出车量、欲派无车量等进行回顾性统计分析.结果 日急救呼叫电话时段分布:在4:00～6:00 最少,在8:00～10:00最多,以后呈缓慢下降趋势.日出车量分布趋势与急救呼叫电话量分布趋势基本一致.日欲派无车量分布:4:00～6:00最少,10:00～12:00最多,此外,交接班、就餐时段欲派无车量也相对较高.结论 北京120院前急救呼叫需求量具有时间分布特点,进一步调整和完善急救资源配置将有利于提高院前急救工作效率,减少欲派无车量.

目的 在借鉴有关城市公共设施布局研究的基础上,完善院前急救网络布局方法,制定北京市城区急救网络合理布局方案,使每一位患者在需要急救的时候能够得到及时、有效、公平地救治.方法 文献学习建立本研究的理论模型,在现况调查的基础上进行数据分析.结果.北京市城区不同区域、不同时间段救护车平均行驶速度不同,城区救护车平均行驶速度为(32.07±14.73)km/h,75%在19.05～26.24 km/h之间;城区道路曲度系数为1.6.以75%救护车能够达到的平均行驶速度、8 min道路行驶时间、道路曲度系数1.6为布局参数,制定理论布局方案,城区共应规划建设200个急救站.结论.在北京市城区建设200个急救站,75%的救护车在执行任务时的急救呼叫反应时间能够达到12 min,基本满足疾病对院前急救的需求,同时接近国际发达国家水平.

Objective To discover features and trend of trauma related emergency call of Beijing 120 pre-hospital emergency call triage in 2010,so as to develop countermeasure for on-site trauma management.Methods Based on Beijing Emergency Medical Center dispatch information database,an analysis was made retrospectively on the characteristic of disease formation,peak time distribution and causes of injury among the Beijing 120 pre-hospital emergency call in 2010.Results Among the whole year 120 pre-hospital emergency calls which totally were 343 119,the first three diseases were trauma accounting for 19.81%(including traffic injury and other trauma),cerebrovascular disease 14.30%,and cardiovascular disease 13.07%.The whole year trauma-related emergency calls were mainly distributed between the 5th~11th month.Among the calls for help in each kind of wound,the transportation wound came in first.Conclusion The features of trauma-related emergency call of Beijing 120 pre-hospital emergency call are as follows:trauma takes the first place in 2010 Beijing 120 pre-hospital medical care disease classification and transportation wound is a leading cause of wound calls for help,which is timely distributed.Therefore we need to take more effective coping strategies to reduce the happening of trauma,and further develop the abilities and levels of pre-hospital trauma management.