Page 26 - 104年11月消防月刊(全)
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工作研討 Work Discussion
高雄市政府消防局建置
消防救護車「即時傳輸 12 導程
心電圖系統」與提升執行率
Establishment of the Kaohsiung City Government Fire Department
The fire engine and ambulance immediately accessible ECG system
and improvements to implementation rates
■文／高雄市政府消防局 洪松銘、高雄榮民總醫院心臟科 黃偉春
■圖／洪松銘、黃偉春提供
上升型心肌梗塞的早期灌注治療是非常重要的。到院前心電圖可以縮短心導管檢查時間及
ST避免二度轉院困擾，進而提早進行心導管灌注治療。然而因國情不同，在臺灣或亞洲設立
到院前心電圖，仍是具有挑戰性的研究主題，本研究期許經由品管方法提升高雄市胸痛病人救護車到
院前心電圖執行率。
壹、推廣理念
一、前言
臺灣自 97 年起陸續有醫學中心測試，但一直都未能成功建置到院前心電圖。針對急性 ST 段上
升型心肌梗塞，病患死亡率與症狀發作至第一次氣球擴張時間（Symptom onset- to- balloon time 亦即
心肌缺氧時間）息息相關。此時間可以分成兩部分，分別是症狀發作至醫院求診時間，加上到院後緊
急心導管時間；但往往症狀發作至醫院求診時間不容易掌握且與病患的認知有關，不容易改善，故各
大醫院莫不盡力於改善到院後緊急心導管時間，以期縮短病患心肌缺氧時間，進一步降低死亡率。
Early percutaneous treatment is very important for ST-segment elevation myocardial Infarction. Carrying
out ECG before arrival at hospital can shorten cardiac catheterization time and avoid the need for transfer,
allowing Percutaneous Coronary Intervention to be carried out promptly. However, as conditions different
between countries, establishing ECG before arrival at hospital in Taiwan and Asia is a challenging research
topic. This study seeks to raise the rate of Kaohsiung City patients with chest pains receiving ECG in the
ambulance before arrival at hospital using quality management methods.
Successive tests have been carried out by medical centers in Taiwan but pre-hospital arrival ECG has not been
successfully established. For acute ST-segment elevation myocardial Infarction “symptom onset- to- balloon
time” (the time of myocardial ischemia) is closely connected to mortality rate. This time can be divided into
two parts: symptom onset to hospitalization time and emergency Percutaneous Coronary Intervention at
hospital time, however symptom onset to hospitalization time is not easily grasped and is related to patient
awareness so is not easy to improve; thus, all big hospitals are striving to improve emergency Percutaneous
Coronary Intervention at hospital time to shorten the amount of time patients suffer myocardial ischemia and
thus lower the mortality rate.
24 消防月刊 2015.11
