目的比较北京和巴黎社区获得性肺炎的急诊治疗情况。方法收集2003年10月1日至2004年9月30日北京大学人民医院急诊科和巴黎市中心H(?)tel-Dieu 医院急诊科的社区获得性肺炎患者病情和治疗方面的信息,通过Fine危险分层评估两组患者,并对治疗进行比较。结果(1)两组患者在五个 Fine分级中的分布差异没有统计学意义(P>0.05),因此两组患者病情有可比性。(2)北京组患者和巴黎组相比,三代头孢类、碳青霉烯类等高级抗生素的用药比例高(P<0.01),而青霉素和大环内酯类用药等基础药物的比例低(P<0.01);静脉用药比例高,而口服药比例低(P<0.01)。北京组病人抗生素治疗和指南的一致性(59.6%)显著低于巴黎组患者(88.6%,P<0.01)。(3)北京组患者全部在4 h 内得到抗生素治疗,而巴黎组患者92例(52.2%)在4 h 内得到抗生素治疗。(4)急诊观察室停留时间北京组患者显著长于巴黎组患者。结论北京和巴黎社区获得性肺炎的急诊处理有很大的不同,我们应借鉴巴黎,以完善自己。
Objective: Endotr.cheal intubation (ETI) is a life-saving emer.ency pr.cedur., but it is a complex skill that is difficult to teach. r.cent studies have shown that video lar.ngoscopy is effective in teaching ETI to le...
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Objective: Endotr.cheal intubation (ETI) is a life-saving emer.ency pr.cedur., but it is a complex skill that is difficult to teach. r.cent studies have shown that video lar.ngoscopy is effective in teaching ETI to lear.er. at var.ous levels of medical exper.ise;however. it has pr.ven to be costly and pr.vides images of inconsistent quality. In this educational pr.of of concept feasibility convenience sample pilot study, we aim to explor. and compar. the effectiveness of using modified Google Glass? (GG) and GoPr.? (GP) technologies to visualize and teach ETI to cr.tical car. physicians in the auster. medical envir.nment of a low-income countr.. We pr.pose, based on our.findings, that this inexpensive technology could teach lifesaving ETI to pr.-hospital pr.vider. in the auster. medical envir.nment, medical students, r.r.l emer.ency physicians, cr.tical car. physicians in low-income countr.es, far.for.ar. militar. medical pr.vider., and other.lear.er.. Methods: A case ser.es of twenty-five patients, five in the United States (US) at Memor.al Hospital in South Bend, IN and twenty at Saint Luc’s Hospital in Por. Au Pr.nce, Haiti, is pr.sented. These patients wer. collected fr.m November.1st 2015 thr.ugh Febr.ar. 1st of 2016. The anesthesiologist and the emer.ency physicians in the United States utilized GG to intubate five patients in the US pr.or.to the twenty patients intubated dur.ng two separ.te tr.ps to Haiti. On the two separ.te tr.ps to Haiti, the GG was tr.aled and modified to obtain better.exposur.. These adaptations r.sulted in the final collection of twenty patients studied with the adapted GG system and GP. Physicians gr.ded air.ay visualization based on LEMON and Cor.ack-Lehane scor.s. Pr.viously published par.meter. for.the assessment of failed intubation r.sk and passage of the cor.s wer. used as data points for.analysis using a Liker.-Scale analysis for.each par.meter. The data wer. analyzed by aver.ges of Liker.-Scale scor.ng with their.r.spective sta
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