Background Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. Method A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. Results One hundred one referrals were eventually included. The mean age of participants was (58.3±11.69) years, predominantly male (67.32%, n=68), with a mean BMI of 22.48±2.2. The mean referral time among participants was 2.26 ± 0.26 hours, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n=54) of participants were conscious, 73.26% (n=74) were in the supine position, 23.76% (n=24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n=6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n=4), followed by the heel (30%, n=3) and nose bridge (20%, n=2) caused by the respiratory devices and spinal board. Conclusion During long ambulance referrals, the prevalence of MDRPIs is higher than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.
Background Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer. Method A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers. Results One hundred one referrals were eventually included. The mean age of participants was (58.3 ± 11.69) years, predominantly male (67.32%, n = 68), with a mean BMI of 22.48 ± 2.2. The mean referral time among participants was 2.26 ± 0.26 h, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n = 54) of participants were conscious, 73.26% (n = 74) were in the supine position, 23.76% (n = 24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n = 6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n = 4), followed by the heel (30%, n = 3) and nose bridge (20%, n = 2) caused by the respiratory devices and spinal board. Conclusion MDRPIs are more prevalent during long ambulance referrals than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.
The impact of domestic waste separation in each province needs to be arranged taking into account the actual situation of carbon emission control, so that the situation of carbon emission control of domestic waste separation is more reasonable. This paper establishes an entropy weighting model to analyze all the factors influencing the development of carbon emission control of domestic waste separation, so that we can get the weights of carbon emission control caused by the carbon emission control index of domestic waste separation. A comprehensive evaluation model is established to score the relevant indicators using the previous weights, so as to be able to derive the amount of influence and compare the influence caused by carbon emission control, so as to complete the classification and get the correlation between municipal domestic waste classification and carbon peak carbon neutrality. For its future development path to be analyzed, suggestions are given and the study is completed.
Background China's PEMS system was established in the 1980s. Due to economic and resource inequalities, China's PEMS system does not have a uniform mode, and regions developed their models based on their circumstances, incorporating North America’s and Europe’s experiences. In the Sichuan PEMS model, when someone calls "120" for a pre-hospital emergency, he/she will first access the Medical Emergency Center, a dispatcher will record the incident information and makes a preliminary judgment, then that information and the judgment will be forwarded to a nearby general hospital, which will send an ambulance staffed by medical workers to provide PEMS. Instead, some people prefer to call hospitals directly for pre-hospital emergencies and communicate directly with medical staff. Which call mode is better has long been a point of contention. Methods This retrospective study included a total of 496 PEMS within 8 km of the participating hospital between 2020 and 2021. Cases that called the Emergency Medical Center dispatcher were classified as "referral group" (n = 318) and cases that called the hospital and communicated directly with medical personnel were classified as "direct group" (n = 178), and appropriate metrics were selected to measure efficiency and information accuracy Results There was no significant difference in the efficiency of PEMS between the two groups, but there was a notable difference in the information accuracy between the two groups on all indicators Conclusion Compared with calling ‘120’, direct PEMS calls to general hospitals have obvious advantages in terms of information accuracy. Perhaps the Emergency Medical Center in Sichuan could try to reform as a supervisory agency for PEMS instead of a dispatch agency or adopt the Shenzhen EMS model where the Emergency Medical Center, after receiving a call for help, transfers the call to the appropriate hospital based on the caller's location and situation, allowing the caller to communicate directly with medical personnel.
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