目的 分析比较住院与非住院患者启动快速反应系统（rapid response systems,RRS）的早期干预效果。方法 回顾性分析2016年1月—2021年12月浙江省某三级甲等医院启动RRS事件的患者资料,比较住院与非住院患者在启动时间、原因、人员和结局方面的区别。结果 2016年—2021年共启动RRS 983例次,主要启动者是护士（94.80%）,住院患者启动715例次（72.74%）,非住院患者启动268例次（27.26%）。住院患者与非住院患者RRS启动后急救医疗小组（emergency medical team,MET）响应时间分别为3（2,4） min和2（1,3） min,就诊科室分别为外科（55.81%）和心血管内科（31.34%）,启动RRS的主要原因分别为患者突发意识丧失（69.23%）和目击患者突然倒地（57.84%）,92.77%需要进行现场干预。住院患者启动RRS时间分布较均匀,非住院患者的RRS启动时间集中分布在08：00—16：00。结论 住院患者和非住院患者RRS启动后MET在5 min内到达,非住院患者在RRS启动时间、地点、原因及结局上与住院患者存在区别,需要关注非住院患者院内病情突发变化时RRS的启动,建议针对全院所有人员开展RRS相关培训和模拟演练。
Objective To analyze and compare the difference of early intervention effect of initiating the rapid response system（RRS）between hospitalized and non-hospitalized patients. Methods The RRS events initiated in a tertiary class A hospital in Zhejiang Province from January 2016 to December 2021 were collected retrospectively. Differences of initiating time,reasons,personnel and patient outcome between hospitalized and non-hospitalized patients were analyzed. Results From 2016 to 2021,983 RRS events were initiated,including 715 inpatients（72.74%）and 268 non-hospitalized patients（27.26%）. The main initiators of RRS were nurses（94.80%）. The res-ponse time of the emergency medical team（MET）after the initiation of RRS was 3（2,4）minutes and 2（1,3）minutes for inpatients and non-hospitalized patients respectively. The visiting departments were surgery（55.81%）and cardiovascular medicine（31.34%）. The main reasons for initiating RRS were sudden loss of consciousness（69.23%）and witnessing patients falling to the ground suddenly（57.84%）. Most required on-site intervention（92.77%）after the initiation of RRS. There was no particularity in the distribution of RRS initiating time periods for inpatients,while the initiating time of RRS for non-hospitalized patients was from 08：00 to 16：00. Conclusion Under homogeneous management,both inpatients and non-hospitalized patients reached MET within 5 minutes after the initiation of RRS. Non-hospitalized patients differed from hospitalized patients in terms of time,place,reasons,and outcome. Attention needs to be paid to the initiation of RRS when the condition of non-hospitalized patients suddenly change in the hospital. It is recommended to carry out RRS-related training and simulation exercises for all personnel in the hospital.
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