2015-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/649803摘要：緊急醫療系統(EMSS)銜接醫療，衛生與公共安全三大領域，攸關公眾健康與醫療事故緊急應變的樞紐，提升其品質是不容忽視的議題。到院前心跳停止病患(OHCA)的存活率，最能反應一個社會緊急醫療照護的整體水準，目前國際間均以標準Utstein 格式來研究OHCA 流行病學，評估緊急醫療系統成效。Utstein 格式包括病患因素，事件因素，現場急救因素，以及預後，可比較不同EMSS 急救復甦成效。透過網頁介面與網路的速捷，可同時多後端(橫跨衛生及消防系統)資料上傳、查詢、監測、與長期追蹤個案預後，建立EMS 資料的整合架構。網路化OHCA 登錄追蹤系統，可減少原本含消防、醫院、及管理人員重複抄寫或輸入資料與往返寄送紙本檔案之困擾。本團隊自2008 年起，已成功建置Utstein 格式「網路化OHCA 登錄系統」並自2010 年6 月於台北市正式使用。國際經驗顯示，政府或公共衛生健康照護單位應建立EMS 品質管理與評估架構，藉由指標數據監控、分析、追蹤，達到品質管理與提昇目標。而因OHCA 復甦存活可作為評估緊急醫療系統的重要依據，因此，建置OHCA 復甦品管評估架構，開發新指標偵測，優化復甦資源配置，可作為「緊急醫療品質管理」的最重要依據與主體。本研究計畫欲優化緊急醫療派遣，創新視訊實境報案系統，研發自動化復甦品質評估技術，與探討公眾去顫系統策略部署的可近性，對公眾健康緊急醫療的發展與提昇，至為樞鑰。本計畫為參年度之連續計畫，以本研究團隊已建立的「網路化心跳停止病患(OHCA)登錄系統」為流行病學資料基礎，(1) 優化緊急救護派遣系統：重點在設計派遣旁觀者對院外心跳停止儘早復甦之流程系統，提升派遣旁觀者儘早復甦率，研發建置視訊實境輔助救護報案系統與其延伸應用- 對突發心跳停止與急重症儘早復甦。(2)研發自動化復甦品質評估技術，創新應用於評估到院前心肺復甦品質：運用電腦視覺偵測技術自動化評估復甦品質，結合OHCA 登錄系統實證資料，創新分析救護車中傳統人為與自動CPR 機之復甦品質與對患者預後的影響。(3)探討公眾去顫系統的可近性：結合OHCA 登錄系統資料，應用地理資訊系統空間與時間分析工具，研究垂直向度空間與策略性部署公眾PAD 之可近性，與對OHCA 存活影響。<br> Abstract: Optimizing Emergency Medical Dispatch (EMD), Innovating Immersive Videotelephony Call(iDispatch), Automating CPR Quality Motion Analysis, and Comprehensive Analyzing PAD Spatial andTemporal Accessibility to Enhance Early Resuscitation Performance- Link with Cardiac Arrest Registry.Emergency Medical Service System (EMSS) is critical to public health system across three majordimensions including medical care, health, and public safety. The continuous quality assurance of EMSSshould not be overlooked. The survival of out-of-hospital cardiac arrest (OHCA) could mostly reflect thelevel of EMSS in a community. Currently the Utstein Style format composed of patient, event, prehospitalemergency care characteristics, and outcome is widely utilized for international OHCA researches, EMSSevaluations and comparisons among various EMSS.Web-based model for registry may facilitate timely recordings and improve data accuracy. It may savetime that individual EMS healthcare providing unit could input optimal data directly from end-user domainthrough web-links, without frequent or multilateral communications between each unit, and could retrievethe results easily. Our team has successfully established an Utstein Style “Web-based OHCA Registry”system well running online since June 2010.The experiences from U.S indicated that government or health authority should implement andmaintain a quality evaluation system of EMSS, to achieve continuous health quality promotion throughmonitoring, analyzing, and exploring the Key Performance Indicators (KPI). Resuscitation of OHCA iscrucial to EMSS performance. An excellent quality evaluation system of OHCA resuscitation performanceis the key to success for better EMSS. Constructing OHCA resuscitation quality framework, exploring EMSresuscitation KPIs, and optimizing the resources are the cores for EMS quality management. In this projectour proposal will be focused on optimizing Emergency Medical Dispatch (EMD), innovating an immersivevideotelephony call system (iDispatch), automating computerized CPR quality motion analysis, andanalyzing Public AED (automated external defibrillator) spatial and temporal accessibility to enhance earlyresuscitation performance.In conjunction with the epidemiology database with OHCA registry, the proposing 3-year project is (1)to optimize EMD, to innovate an immersive videotelephony dispatch system, and to improve call-to-chestcompression time; (2) to develop an automated computerized CPR quality motion analysis system, and toevaluate CPR quality during ambulance transport and its impact on patient survival in both manual CPR andmechanical device CPR; and (3) to analyze Public AED spatial and temporal accessibility utilizing dynamicGIS technology, in order to enhance early resuscitation performance and public emergency healthcare.到院前心跳停止網頁登錄系統緊急醫療系統緊急醫療派遣視訊報案系統影像感測心肺復甦品質公眾去顫地理資訊系統Out-of-hospital Cardiac Arrest (OHCA)Web RegistryEmergency Medical Service (EMS) PerformanceEmergency Medical DispatchVideotelephonyMotion Detection AnalysisCardiopulmonary Resuscitation (CPR) QualityPublic Access