Emergency department is the preface window for all kinds of critically ill patients. After the diagnosis of emergency department, it is often sent to the ward for further specialist treatment after treatment. In the daily work of emergency department, the patient's hospital transshipment is very common, but Often hospital transshipment, whether equipment or personnel arrangements are obvious shortcomings, so seemingly "relatively safe" hospital transshipment in fact there is a great risk. According to Evans and Winslow et al reported in-transit transport of critical transit transit mortality was 9.6% higher than usual. Therefore, the nature of the work of nurses determines the role of nurses in the transport of patients play a leading role. The department to June 2014 plus a shovel stretcher transport critically ill patients have achieved good results, are as follows.

1 Materials and methods

1.1 General Information: Random selection of our hospital emergency department in July 7-12 in the treatment of 82 patients with critically ill patients, including 47 males and 35 females; aged 19-54 years; height fall injury in 15 cases, traffic accident injury 32 cases, 15 cases of cerebrovascular accident, spinal fractures in 10 cases, 10 cases of pelvic fracture, as an ordinary stretcher group; random selection of our hospital emergency department in July 7 to 12 months plus shovel stretcher transport of critically ill patients 79 cases , Including male 50 cases, female 29 cases; aged 21-56 years; height fall injury in 17 cases, traffic accident in 28 cases, 14 cases of cerebrovascular accident, spinal fractures in 9 cases, 11 cases of pelvic fractures, group. There was no significant difference in sex, age and disease between the two groups (P> 0.05).

1.2 Materials and methods: ordinary stretcher group using the hospital's ordinary flat car, pull the fence on both sides, handling directly by the transfer of nurses to guide the families of patients moved to the flat car; shovel stretcher group selected by the Jiangsu Rongchang company models For the RC-B-2 is not scalable, specifications for the 170 cm x42 cm of the two aluminum alloy plate composition, to draw and open, handling directly by the transfer of nurses to guide the families of two metal plates from the wounded back into the sides, Press the clutch device at both ends after the patient fixed in the flat car, and then pull up both sides of the fence can be flat car.

1.3 Observation of indicators: observation and comparison of two groups of patients from the emergency department to the ward the time required to carry the patient's subjective pain and various types of catheter slip rate.

1.4 Statistical analysis: Statistical analysis using SPSS19.0 statistical software, measurement data expressed as mean ± standard deviation, count data expressed as a percentage, the sample rate and the composition of the comparison using χ 2 test, the comparison of two sample mean T test, P <0.05 for the difference was statistically significant.

2 Results

2.1 The two groups of patients from the emergency department to the ward of the transit time required, which is divided into emergency room to the examination room, check the handling and examination room out to the ward three time periods to compare the two groups were statistically significant difference (P <0.05).

2.2 Evaluation of pain during transport in two groups: Pain was defined as painful and unpleasant subjective feelings in 2001 by the International Association for the Study of Pain (IASP) , Accompanied by existing and potential tissue damage. In clinical work, the pain has become the body temperature, pulse, respiration, blood pressure after the first five vital signs, severe trauma, spinal injury, multiple injuries in the handling of patients will be severe acute pain, severe acute pain can lead to The body produces stress, catecholamines and other substances increased secretion, causing pulse, breathing speed, blood sugar, increased oxygen consumption; interference with the stability of the environment, affecting the body function of multiple systems, the body immunity decreased infection And other complications increased, delayed rehabilitation. Our subjects through the use of a spatula stretcher significantly reduced the subjective pain, the two groups of patients with subjective pain was significantly different (P <0.01).

2.3 The two groups of common types of adverse catheterization incidence of the correlation analysis: This study observed during transport common catheter (oxygen tube, infusion tube, tracheal tube, tube, deep venous catheter, drainage tube, catheter) The incidence of unintentional accidents in the two groups was statistically significant (P <0.05). The incidence of adverse events in the two groups of patients was significantly higher than that in the control group (P <0.05).

3 Discussion

3.1 The use of shovel stretcher can significantly reduce the time and improve the efficiency and quality of care: Add a spatula stretcher, significantly shortened from the emergency room to the time required (P <0.05). In the hospital transport process, the patient left the emergency protection of the environment, the nurses became the main transporter process and supervisors, nurses in addition to guiding their families to do the removal work, but also to observe the patient's condition changes, time is Life, time management awareness is particularly important. According to the related literature, the longer transit time, the more likely to change the vital signs of patients, thus minimizing transit transit time, so that critically ill patients can quickly access the emergency department, timely life support, not only can improve the success rate after the rescue And the quality of life of patients, improve the efficiency of emergency transport of critically ill patients, but also enhance the patients and their families on the hospital's sense of security, trust, so as to improve the efficiency and quality of emergency care.

3.2 in the transport process with a shovel stretcher to alleviate the subjective pain in patients: At present, the clinical management of patients with acute traumatic pain in the general view that "pain is normal, patients should tolerate pain should not complain," ignored the right Pain assessment, which sometimes cover up the patient's condition. In this study, we used a shovel-type stretcher to transport critically ill patients in an ordinary flat car, which was easy to grasp and focus on, effectively controlling the patient's balance and relieving the patient's pain during handling. Good support and protective role, nurses and their families with the handling is relatively simple.

3.3 In the transport process to increase the use of shovel stretcher reduces the risk of accidental pipeline: critically ill patients after emergency rescue, the body often with a variety of pipes, if used inappropriate handling, often lead to infusion tube, guide Catheter, artificial trachea, such as shedding or ectopic, which will lead to nursing staff to judge the wrong condition, can also lead to longer transit time, so that patients with increased risk. The results showed that nurse with a shovel stretcher transport patients, a good reduction in the pipeline accident, reducing the risk factor of the patient.

In summary, compared with ordinary flat transport mode, plus a shovel-style stretcher is simple, easy to use, emergency trauma patients transport security greatly improved, worthy of clinical use.