A Novel Model Based on the Trauma Green Channel and Emergency Virtual Ward Improves the Efficiency of the Emergency Process for Ectopic Pregnancy Patients

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Its incidence is increasing globally, and early diagnosis and timely intervention are crucial for reducing mortality and preserving fertility. This study aims to investigate the role of a novel emergency model based on the trauma green channel and an emergency virtual ward in improving the treatment efficiency for patients with ectopic pregnancy. Methods A retrospective study was conducted on 63 ectopic pregnancy patients who underwent emergency surgery in our hospital between January 2023 and April 2025. They were divided into a traditional model group (31 cases) and a trauma care model group (32 cases). General clinical data and eight emergency quality control indicators were collected and compared, including patient admission time, time to establish effective circulatory access, time to perform color Doppler ultrasound, time to obtain urine pregnancy test results, time to obtain serum β-hCG results, time to definitive diagnosis, time to enter the operating room, and satisfaction score with emergency care. Results No significant differences were found between the two groups in terms of age, vital signs, or length of hospital stay (P > 0.05). The trauma care model group had significantly lower total medical costs (P = 0.002) and a higher rate of fallopian tube preservation (43.8% vs. 19.4%, P = 0.034) compared to the traditional model group. Furthermore, the trauma care model group demonstrated significantly better results in all eight emergency quality control indicators (P < 0.05), and patient and family satisfaction with the emergency process was also significantly higher (P = 0.013). Conclusion The novel trauma emergency model for ectopic pregnancy, based on the trauma green channel and the emergency virtual ward, significantly optimized the emergency process, shortened key time points, reduced medical costs, and helped improve the rate of fertility preservation and patient satisfaction with emergency care. It demonstrates good value for clinical application and promotion. Ectopic Pregnancy Trauma Care Model Green Channel Virtual Ward Emergency Process Multidisciplinary Team (MDT) Figures Figure 1 Figure 2 Introduction Ectopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, with tubal pregnancy being the most common type, accounting for approximately 95% of cases[1]. Studies have shown that its occurrence is closely related to factors such as pelvic inflammatory disease, history of ectopic pregnancy, and the use of assisted reproductive technologies[2]. In recent years, with the trend of delayed childbearing and rising rates of pelvic infections, the global incidence of ectopic pregnancy is about 1%-2%, and the incidence in China also reaches 1.5%-2.0%. The incidence has increased 4–6 fold over the past 30 years, making it one of the leading causes of maternal death in the first trimester, accounting for 2.7% of pregnancy-related deaths[3][4]. Once ruptured, ectopic pregnancy can lead to intra-abdominal hemorrhage and hemorrhagic shock, severely threatening the patient's life[5]. Currently, the diagnosis of ectopic pregnancy primarily relies on transvaginal ultrasonography and dynamic monitoring of serum beta-human chorionic gonadotropin (β-hCG) levels[6]. Treatment options include medical management, surgical intervention (typically laparoscopy), and expectant management. The choice depends on the patient's hemodynamic status, β-hCG levels, size of the gestational mass, and fertility desires[7]. Regardless of the approach, the treatment principles revolve around three key goals: "saving lives, removing the ectopic pregnancy, and preserving fertility"[5]. Therefore, establishing an efficient and standardized in-hospital emergency process for early diagnosis and rapid intervention is crucial for improving prognosis and preserving reproductive potential[8][9]. Although mature "green channel" models for trauma, chest pain, and stroke have been established domestically and internationally, significantly improving treatment efficiency[10][11], the exploration of structured emergency systems specifically for ectopic pregnancy, a unique obstetric and gynecological emergency, remains insufficient. Traditional emergency models often suffer from delays due to imprecise triage, poor coordination between departments, and long waiting times for examinations[12]. Inspired by the multidisciplinary team (MDT) concept and process optimization principles of trauma centers[13][14], and leveraging the advantages of the emerging "virtual ward" in integrating medical resources[15], our hospital attempted to integrate the trauma green channel with the emergency virtual ward to create a dedicated emergency model for ectopic pregnancy. This study aims to evaluate the effectiveness of this novel model in improving the efficiency of the emergency process for ectopic pregnancy patients by comparing it with the traditional model. 1. Research Objects and Methods 1.1 Research Objects A retrospective study was conducted on patients diagnosed with ectopic pregnancy who were admitted through the Emergency Surgery department of our hospital and underwent surgical treatment between January 2023 and April 2025. Based on the treatment mode, they were divided into a traditional care model group (31 cases) and a trauma care model group (32 cases). Inclusion criteria:(1) Surgically confirmed ectopic pregnancy; (2) Admission through the Emergency Surgery department. Exclusion criteria:(1) Patients seen in the outpatient department or receiving non-surgical treatment; (2) Patients with cesarean scar pregnancy or cornual pregnancy; (3) Patients with incomplete clinical data. The specific screening process is shown in Fig. 1 . 1.2 Research Methods 1.2.1 Human Resource Configuration Traditional Model: No fixed team. Initial diagnosis was made by rotating doctors in the emergency department. After diagnosis, patients transferred to the Obstetrics and Gynecology department on their own or accompanied by one nurse. The trauma center used a one-doctor, multiple-nurses model, but nurse roles were unclear, and team collaboration training was lacking. Novel Model: An ectopic pregnancy MDT team was established, consisting of emergency surgeons, obstetrician-gynecologists, laboratory staff, and ultrasonographers. A fixed team model of "two doctors and two nurses" was adopted (one emergency surgeon, one obstetrician-gynecologist, one trauma nurse, one intravenous access nurse), with clearly defined responsibilities. In addition to monthly routine training and assessment, regular team simulation drills and specialized training for critically ill patient transport were conducted. 1.2.2 Treatment Process Traditional Model: (1) Initial Assessment and Management: After the patient arrives at the hospital, triage staff inquire about the patient's general condition to preliminarily confirm the possibility of ectopic pregnancy and notify the emergency surgeon. (2) Subsequent Examinations: The doctor on duty conducts routine tests and examinations to confirm the diagnosis of ectopic pregnancy, with priority given to critically ill patients. However, this expedited service is limited to within the emergency department. (3) Ectopic Pregnancy Alert Activation: After confirmation, the obstetrics and gynecology department is contacted for admission. Emergency medical staff assist with the transfer to the obstetrics and gynecology ward throughout the process. (4) Subsequent Treatment: After entering the ward, subsequent treatment is led by the obstetrics and gynecology doctor on duty. Novel Model: (1) Ectopic Pregnancy Alert Activation: After the patient arrives at the hospital, well-trained triage staff inquire about the patient's general condition to preliminarily confirm the possibility of ectopic pregnancy and notify the emergency surgeon, thereby immediately activating the ectopic pregnancy alert. (2) Initial Assessment and Management: The emergency surgeon assesses the patient's general condition. The patient is moved to the resuscitation room for vital signs monitoring. (3) Subsequent Examinations: Rapid tests and examinations are performed via the green channel. (4) Subsequent Treatment: The patient is admitted to the emergency virtual ward. An obstetrics and gynecology doctor arrives on site within 10 minutes to assess the patient for subsequent treatment. A hospital-wide ectopic pregnancy green channel service system is established to ensure priority treatment for ectopic pregnancy patients across all relevant departments. In cases requiring urgent blood transfusion, the emergency surgeon or nurse can promptly notify the blood bank by phone to ensure timely transfusion. Patients with surgical indications receive priority for surgery. The obstetrics and gynecology doctor completes preoperative preparation in the resuscitation room via the virtual ward system, and the patient is transported directly from the emergency resuscitation room to the operating room within 30 minutes of admission to shorten surgical wait times. Furthermore, if patients face difficulties with medical payments, the principle of "treat first, pay later" applies to avoid delays in treating critically ill patients. Patients assessed as suitable for conservative treatment are transferred from the virtual ward to the obstetrics and gynecology ward for subsequent management. 1.2.3 Emergency Protocol Traditional Model Triage → Reception by emergency surgeon → Ordering tests → Patient completes tests independently → Contact Obstetrics & Gynecology after confirmation → Transfer to ward → Treatment arranged by OB/GYN doctor. Novel Model : (A) Admission 0 minutes: Experienced triage staff activate the alarm and initiate the MDT upon initial suspicion of ectopic pregnancy. (B) Admission 5 minutes: Patient enters the resuscitation room. Emergency bedside ultrasound, urine pregnancy test, and blood β-hCG test are completed via the green channel. (C) Admission 10 minutes: Upon confirmation, the OB/GYN doctor arrives at the resuscitation room (virtual ward) within 10 minutes. The trauma nurse monitors vital signs, and the IV access nurse establishes venous access. The emergency surgeon performs the initial assessment and provides necessary support. (D) Admission 25 minutes: The OB/GYN doctor re-evaluates and decides the treatment plan. Patients requiring surgery complete preoperative preparation and consent discussions within the virtual ward and are transported directly to the operating room by the team. Patients eligible for conservative treatment are transferred to the OB/GYN ward. (E) Admission 30 minutes: Patient enters the operating room. The principle of "treatment first, payment later" is implemented throughout the process. (The specific flowchart is shown in Fig. 2 . Differences between the two models are summarized in Table 1 .) Table 1 Differences Between the Traditional Care Model and the Trauma Care Model Item Traditional Care Model Trauma Care Model Human Resources Ectopic Pregnancy MDT Team No Yes Medical Staff Model One-doctor, multiple-nurses model Two-doctors, two-nurses model Nurses have no clear division of responsibilities Each member has clearly defined responsibilities Training and Assessment Monthly training and assessment Monthly training and assessment No team collaboration training Team collaboration training is conducted Methods Ectopic Pregnancy Alert Activation Activated only after confirmation Activated upon triage suspicion Initial Assessment and Management Performed by triage staff Performed by an emergency surgeon Subsequent Examinations Routine emergency process Emergency green channel Subsequent Treatment Transferred to OB/GYN department first Directly to the operating room via the emergency virtual ward 1.2.4 Observation Indicators Eight emergency quality control indicators were recorded and compared: (1) Admission Time The time from the patient's first medical contact to being received by the emergency surgeon. (2) Time to Establish Effective Circulatory Access The time from being received by the emergency surgeon to the establishment of effective circulatory access. (3) Time to Perform Color Doppler Ultrasound The time from the emergency surgeon ordering the examination to the performance of the color Doppler ultrasound. (4) Time to Obtain Urine Pregnancy Test Results The time from the emergency surgeon ordering the test to the issuance of the urine pregnancy test results. (5) Time to Obtain Serum β-Human Chorionic Gonadotropin (β-hCG) Test Results The time from the emergency surgeon ordering the test to the issuance of the serum β-hCG test results. (6) Time to Definitive Diagnosis The time from the patient's first medical contact to the definitive diagnosis. (7) Time to Enter Operating Room The time from the definitive diagnosis of ectopic pregnancy to entering the operating room. (8) Patient and Family Satisfaction with Emergency Care A survey of patient and family satisfaction regarding the emergency response time, process, and success rate. 1.3 Statistical Methods Statistical analysis was performed using SPSS 21.0 software. Measurement data are expressed as mean ± standard deviation (x ± s), and intergroup comparisons were made using the t-test. Count data are expressed as number (percentage), and intergroup comparisons were made using the χ² test or Fisher's exact test. Ranked data were analyzed using the rank-sum test. A P value < 0.05 was considered statistically significant. 2. Results 2.1 Comparison of General Patient Data Between the Two Groups A total of 63 patients were included. There were no statistically significant differences between the two groups in age, vital signs at admission (body temperature, heart rate, respiration, blood pressure), or length of hospital stay (P > 0.05), indicating comparability. However, the total medical cost in the trauma care model group was significantly lower than that in the traditional model group (P = 0.002), and the fallopian tube preservation rate was significantly higher in the trauma care model group (43.8% vs. 19.4%, P = 0.034). Details are shown in Table 2 . Table 2 General Clinical Characteristics of Patients in the Traditional Care Model and the Trauma Care Model Traditional Care Model (n=31) Trauma Care Model (n=32) p-value Age (years) 33.29 ± 5.26 30.78 ± 6.59 0.133 Surgical Approach 0.034 *Salpingostomy (Fallopian Tube Preserved) 6 (19.4%) 14 (43.8%) *Salpingectomy (Fallopian Tube Removed) 25 (80.6%) 18 (56.3%) Vital Signs *Body Temperature (°C) 36.53 ± 0.27 36.63 ± 0.28 0.323 *Heart Rate (beats/min) 89.61 ± 15.60 85.94 ± 10.64 0.078 *Respiratory Rate (breaths/min) 19.03 ± 1.14 18.97 ± 1.09 0.852 *Systolic Blood Pressure (mmHg) 107.77 ± 15.44 113.47 ± 20.83 0.212 *Diastolic Blood Pressure (mmHg) 69.10 ± 12.31 74.09 ± 12.53 0.504 Length of Hospital Stay (days) 5.10 ± 2.94 4.88 ± 1.24 0.285 Total Cost (RMB) 10933.16 ± 2843.31 10068 ± 1175.32 0.002 2.2 Comparison of Emergency Quality Control Indicators Between the Two Groups As shown in Table 3 , the trauma care model group performed significantly better than the traditional model group on all eight time indicators (P < 0.001), including admission time, time to establish effective circulatory access, time to complete various examinations and obtain results, time to definitive diagnosis, and time to enter the operating room. Simultaneously, the emergency care satisfaction score in the trauma care model group was also significantly higher than that in the traditional model group (P = 0.013). Table 3 Eight Emergency Quality Control Indicators for Patients in the Traditional Care Model and the Trauma Care Model Item Traditional Care Model Trauma Care Model p-value Admission Time (min) 6.58 ± 2.66 3.03 ± 0.78 0.000 Time to Establish Effective Circulatory Access (min) 53.39 ± 20.49 12.50 ± 1.65 0.000 Time to Perform Color Doppler Ultrasound (min) 29.48 ± 15.36 7.75 ± 0.98 0.000 Time to Obtain Urine Pregnancy Test Results (min) 13.58 ± 2.58 4.00 ± 0.80 0.000 Time to Obtain Serum β-hCG Results (min) 49.16 ± 10.79 23.50 ± 0.58 0.000 Time to Definitive Diagnosis (min) 36.61 ± 14.58 10.78 ± 1.26 0.000 Time to Enter Operating Room (min) 76.16 ± 24.05 28.53 ± 1.05 0.000 Patient and Family Satisfaction with Emergency Care (score) 90.64 ± 3.86 96.00 ± 2.58 0.013 3. Discussion This study is the first to apply a structured emergency model integrating the concepts of the trauma green channel and the emergency virtual ward to the management of ectopic pregnancy. The results demonstrate that this model significantly shortens key in-hospital time points, increases the fallopian tube preservation rate, reduces medical costs, and improves patient satisfaction. The management of ectopic pregnancy is a race against time. Both domestic and international studies emphasize that the "golden window" from hospital admission to surgery critically impacts prognosis, particularly the preservation of fertility [16][17]. The traditional sequential, multi-department transfer process has inherent delays [18]. The novel model constructed in this study achieves process reengineering through three core initiatives: First, early warning and MDT linkage. Drawing on concepts like ACiLS for non-traumatic critical care[19][20], the alarm is activated upon triage suspicion, shifting from "initiation after confirmation" to "linkage after warning," placing MDT consultation at the forefront of decision-making, effectively reducing communication barriers and waiting times between departments. Second, spatial and resource integration. The "emergency virtual ward" brings the OB/GYN doctor's consultation space forward to the resuscitation room. Combined with the green channel ensuring priority for examinations, it realizes an efficient operational model where "the patient remains stationary, while information and doctors move," aligning well with the "one-stop" treatment concept pursued by modern emergency medicine [21][22]. Third, process standardization and team specialization. A fixed MDT team with clear division of responsibilities, supplemented by regular team collaboration training, ensures the orderliness and tacit understanding of the rescue process, consistent with the experiences reported by Zhao et al. et al.[10]and Liu and Bai [11] in trauma center construction. The observed higher fallopian tube preservation rate in the trauma care model group is likely attributable to the significantly earlier diagnosis and surgical intervention. When the ectopic pregnancy mass is treated before rupture or in the early stages of rupture, the opportunity to perform fertility-preserving surgery (such as salpingostomy) is greater[23][24]. Meanwhile, the efficiency gains from process optimization, avoiding unnecessary hospital days and related tests, likely contributed to the lower total medical cost in this group, consistent with the view that efficient healthcare models are often more cost-effective[25]. This study has several limitations. First, as a single-center retrospective study, potential selection bias exists, and the generalizability of the conclusions needs further verification. Second, the relatively small sample size may affect the statistical power of some subgroup analyses. Third, a detailed cost-effectiveness analysis of the two models was not performed. Finally, data on long-term postoperative fertility outcomes (such as intrauterine pregnancy rate, recurrent ectopic pregnancy rate) are lacking. Future research directions should include: conducting multicenter, prospective randomized controlled trials to provide higher-level evidence; expanding the sample size and performing subgroup analyses for patients with different severity levels; performing comprehensive health economic evaluations; and establishing long-term follow-up mechanisms to assess the model's long-term impact on patients' fertility quality and quality of life. 4. Conclusion The novel trauma emergency model for ectopic pregnancy, based on the trauma green channel and the emergency virtual ward in our hospital, significantly optimized the in-hospital emergency process, shortened key time points, reduced medical costs, and helped improve the rate of fertility preservation and patient satisfaction with emergency care through multidisciplinary collaboration, process reengineering, and resource integration. It provides an efficient and referable new management model for the emergency treatment of ectopic pregnancy. Declarations Acknowledgment: We thank all authors who contributed valuable methods and data and made them public. Data Availability Statement: All the other data supporting the findings of this study are available within the article and its Supplementary Information Files, or from the corresponding authors upon reasonable request. Disclosure Statement: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Funding: No funding. Conflict of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This work described has not been published previously and not under consideration for publication elsewhere. Ethics Statement: All patients’s data used was anonymized before its use. The ethics committee of Affiliated Taizhou People’s Hospital of Nanjing Medical University exempted the ethical requirements of this study, and all patients have signed informed consent forms. The present study was conducted in accordance with the ethical standards and the Declaration of Helsinki. Clinical trial number: not applicable. Authors Contribution: Fei Qian conceived and designed this study. Lin Sun prepared the figures, analyzed data and wrote the first version of the manuscript. Jianquan You revised the manuscript. All authors have read and approved the final manuscript. References 以下是按**BMC Emergency Medicine** 参考文献格式要求修改后的参考文献部分。该期刊通常要求使用**顺序编号制（citation by numbers）**，文内引用使用方括号数字如[1]，文末参考文献列表按引用顺序排列，并采用标准期刊缩写（如PubMed/NCBI格式）。 Farquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485):583-91. Brim ACS, Barretto VRD, Reis-Oliveira JG, da Silveira de Araújo RB, Romeo ACDC B. Risk factors for ectopic pregnancy occurrence: Systematic review and meta-analysis. Int J Gynaecol Obstet. 2025;168(3):919-32. Hendriks E, Rosenberg R, Prine L. Ectopic Pregnancy: Diagnosis and Management. Am Fam Physician. 2020;101(10):599-606. Bo W, Qianyu Z, Mo L. Global, Regional, and National Burden of Ectopic Pregnancy: A 30-Year Observational Database Study. Int J Clin Pract. 2023;2023:3927337. Mullany K, Minneci M, Monjazeb R, Coiado OC. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health (Lond). 2023;19:17455057231160349. Hao HJ, Feng L, Dong LF, Zhang W, Zhao XL. Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis. Medicine (Baltimore). 2023;102(17):e33621. Canis M, Savary D, Pouly JL, Wattiez A, Mage G. Grossesse extra-utérine: critères de choix du traitement médical ou du traitement chirurgical [Ectopic pregnancy: criteria to decide between medical and conservative surgical treatment?]. J Gynecol Obstet Biol Reprod (Paris). 2003;32(7 Suppl):S54-63. Jurkovic D, Wilkinson H. Diagnosis and management of ectopic pregnancy. BMJ. 2011;342:d3397. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115(3):495-502. Zhao Q, Zhao Y, Ke T, Lin C, Xu Y, Xu Y, et al. The effect of a new in-hospital trauma care model on the outcomes of severely injured trauma patients in the emergency department: a retrospective observational study in China. BMC Emerg Med. 2025;25(1):47. Liu T, Bai XJ. Trauma care system in China. Chin J Traumatol. 2018;21(2):80-3. Barnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med. 2009;361(4):379-87. Riessen R, Bulla P, Mengel A, Kumle B. Initiale Diagnostik und Therapie des Schocks [Initial diagnosis and treatment of shock]. Med Klin Intensivmed Notfmed. 2024;119(8):650-8. Dziegielewski J, Schulte FC, Jung C, Wolff G, Hannappel O, Kümpers P, et al. Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study). BMC Emerg Med. 2023;23(1):43. Suk F, et al. Transforming surgical care: The launch of the UK's first surgical virtual ward for acute and elective patients. Surg Endosc. 2025;39(11):7628-32. Murray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173(8):905-12. Lipscomb GH. Medical therapy for ectopic pregnancy. Semin Reprod Med. 2007;25(2):93-8. Hajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, Van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;(1):CD000324. Condous G, Okaro E, Khalid A, Lu C, Van Huffel S, Timmerman D, et al. The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Hum Reprod. 2005;20(5):1404-9. Kirk E, Papageorghiou AT, Condous G, Tan L, Bora S, Bourne T. The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy. Hum Reprod. 2007;22(11):2824-8. Barnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. 2006;86(1):36-43. Ankum WM, Mol BW, Van der Veen F, Bossuyt PM. Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril. 1996;65(6):1093-9. Stovall TG, Ling FW. Ectopic pregnancy: diagnostic and therapeutic algorithms minimizing surgical intervention. J Reprod Med. 1993;38(10):807-12. Cohen A, Zakar L, Gil Y, Amer-Alshiek J, Amir H, Bilgory A, et al. Methotrexate success rates in progressing ectopic pregnancies: a retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2014;183:81-4. Lipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med. 2000;343(18):1325-9. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8547410","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":588149094,"identity":"11354ed9-23bc-45fe-b733-27ee4a391473","order_by":0,"name":"Lin Sun","email":"","orcid":"","institution":"The Affiliated Taizhou People's Hospital of Nanjing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Sun","suffix":""},{"id":588149095,"identity":"c6837fa3-f0ad-4dc7-a59e-3151aff4a7f2","order_by":1,"name":"Jianquan You","email":"","orcid":"","institution":"The Affiliated Taizhou People's Hospital of Nanjing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jianquan","middleName":"","lastName":"You","suffix":""},{"id":588149096,"identity":"438a717a-1b97-4776-8e0b-1613f5b3dd06","order_by":2,"name":"Fei Qian","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA50lEQVRIie3PsarCMBSA4RMKZjkPUHDoK5xy4W7qs4SAoyhOcgcjhUyFrh18CN9A5aCOroIOiuDkoFsHh2txEYe0o0P+4SSEfJAA+HxfmDDlJABpxORYbmqQ4EVwIRKqRQCC14ILaIT1QLbl27Xf7qFM7KjoHyKQvJo5H5ZriKekh4hLu0e6xAa73Z2bBKCRAjUPld0DsTAh/rpJxsBIY5VGJzsoiDvVxGiRILFKQ2Gh3FSTXP+IKW1UiippPom2VX+Js+X5dn38qVRuTvfiwa1M8tpNzHPg+0nDdb0sgk/i8/l8vs/+AfKDSd96yUckAAAAAElFTkSuQmCC","orcid":"","institution":"The Affiliated Taizhou People's Hospital of Nanjing Medical University","correspondingAuthor":true,"prefix":"","firstName":"Fei","middleName":"","lastName":"Qian","suffix":""}],"badges":[],"createdAt":"2026-01-08 06:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8547410/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8547410/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102746224,"identity":"a15adb31-0f95-406d-9b34-8d9a37ae51fa","added_by":"auto","created_at":"2026-02-16 08:56:09","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":430022,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of Ectopic Pregnancy Case Selection\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8547410/v1/d569d4eee4bf4dacadb1d064.jpeg"},{"id":102441600,"identity":"3ebe2f45-28a2-479d-8532-798f4ddf3f7e","added_by":"auto","created_at":"2026-02-11 16:56:50","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":644499,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart of Trauma Care Model for Ectopic Pregnancy Patients\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8547410/v1/71d8f3ec500d957a61bb54c2.jpeg"},{"id":106412064,"identity":"87d9561a-3ef2-4dae-9489-02fccfabdfd2","added_by":"auto","created_at":"2026-04-08 09:58:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1713793,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8547410/v1/a4274249-8519-4b48-8187-c20fd0026898.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"A Novel Model Based on the Trauma Green Channel and Emergency Virtual Ward Improves the Efficiency of the Emergency Process for Ectopic Pregnancy Patients","fulltext":[{"header":"Introduction","content":"\u003cp\u003eEctopic pregnancy refers to the implantation of a fertilized egg outside the uterine cavity, with tubal pregnancy being the most common type, accounting for approximately 95% of cases[1]. Studies have shown that its occurrence is closely related to factors such as pelvic inflammatory disease, history of ectopic pregnancy, and the use of assisted reproductive technologies[2]. In recent years, with the trend of delayed childbearing and rising rates of pelvic infections, the global incidence of ectopic pregnancy is about 1%-2%, and the incidence in China also reaches 1.5%-2.0%. The incidence has increased 4\u0026ndash;6 fold over the past 30 years, making it one of the leading causes of maternal death in the first trimester, accounting for 2.7% of pregnancy-related deaths[3][4]. Once ruptured, ectopic pregnancy can lead to intra-abdominal hemorrhage and hemorrhagic shock, severely threatening the patient's life[5].\u003c/p\u003e \u003cp\u003eCurrently, the diagnosis of ectopic pregnancy primarily relies on transvaginal ultrasonography and dynamic monitoring of serum beta-human chorionic gonadotropin (β-hCG) levels[6]. Treatment options include medical management, surgical intervention (typically laparoscopy), and expectant management. The choice depends on the patient's hemodynamic status, β-hCG levels, size of the gestational mass, and fertility desires[7]. Regardless of the approach, the treatment principles revolve around three key goals: \"saving lives, removing the ectopic pregnancy, and preserving fertility\"[5]. Therefore, establishing an efficient and standardized in-hospital emergency process for early diagnosis and rapid intervention is crucial for improving prognosis and preserving reproductive potential[8][9].\u003c/p\u003e \u003cp\u003eAlthough mature \"green channel\" models for trauma, chest pain, and stroke have been established domestically and internationally, significantly improving treatment efficiency[10][11], the exploration of structured emergency systems specifically for ectopic pregnancy, a unique obstetric and gynecological emergency, remains insufficient. Traditional emergency models often suffer from delays due to imprecise triage, poor coordination between departments, and long waiting times for examinations[12]. Inspired by the multidisciplinary team (MDT) concept and process optimization principles of trauma centers[13][14], and leveraging the advantages of the emerging \"virtual ward\" in integrating medical resources[15], our hospital attempted to integrate the trauma green channel with the emergency virtual ward to create a dedicated emergency model for ectopic pregnancy. This study aims to evaluate the effectiveness of this novel model in improving the efficiency of the emergency process for ectopic pregnancy patients by comparing it with the traditional model.\u003c/p\u003e"},{"header":"1. Research Objects and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\n\u003ch2\u003e1.1 Research Objects\u003c/h2\u003e\n\u003cp\u003eA retrospective study was conducted on patients diagnosed with ectopic pregnancy who were admitted through the Emergency Surgery department of our hospital and underwent surgical treatment between January 2023 and April 2025. Based on the treatment mode, they were divided into a traditional care model group (31 cases) and a trauma care model group (32 cases).\u003c/p\u003e\n\u003cp\u003eInclusion criteria:(1) Surgically confirmed ectopic pregnancy; (2) Admission through the Emergency Surgery department. Exclusion criteria:(1) Patients seen in the outpatient department or receiving non-surgical treatment; (2) Patients with cesarean scar pregnancy or cornual pregnancy; (3) Patients with incomplete clinical data. The specific screening process is shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\n\u003ch2\u003e1.2 Research Methods\u003c/h2\u003e\n\u003cdiv id=\"Sec5\" class=\"Section3\"\u003e\n\u003ch2\u003e1.2.1 Human Resource Configuration\u003c/h2\u003e\n\u003cp\u003eTraditional Model: No fixed team. Initial diagnosis was made by rotating doctors in the emergency department. After diagnosis, patients transferred to the Obstetrics and Gynecology department on their own or accompanied by one nurse. The trauma center used a one-doctor, multiple-nurses model, but nurse roles were unclear, and team collaboration training was lacking.\u003c/p\u003e\n\u003cp\u003eNovel Model: An ectopic pregnancy MDT team was established, consisting of emergency surgeons, obstetrician-gynecologists, laboratory staff, and ultrasonographers. A fixed team model of \"two doctors and two nurses\" was adopted (one emergency surgeon, one obstetrician-gynecologist, one trauma nurse, one intravenous access nurse), with clearly defined responsibilities. In addition to monthly routine training and assessment, regular team simulation drills and specialized training for critically ill patient transport were conducted.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec6\" class=\"Section3\"\u003e\n\u003ch2\u003e1.2.2 Treatment Process\u003c/h2\u003e\n\u003cp\u003eTraditional Model: (1) Initial Assessment and Management: After the patient arrives at the hospital, triage staff inquire about the patient's general condition to preliminarily confirm the possibility of ectopic pregnancy and notify the emergency surgeon. (2) Subsequent Examinations: The doctor on duty conducts routine tests and examinations to confirm the diagnosis of ectopic pregnancy, with priority given to critically ill patients. However, this expedited service is limited to within the emergency department. (3) Ectopic Pregnancy Alert Activation: After confirmation, the obstetrics and gynecology department is contacted for admission. Emergency medical staff assist with the transfer to the obstetrics and gynecology ward throughout the process. (4) Subsequent Treatment: After entering the ward, subsequent treatment is led by the obstetrics and gynecology doctor on duty.\u003c/p\u003e\n\u003cp\u003eNovel Model: (1) Ectopic Pregnancy Alert Activation: After the patient arrives at the hospital, well-trained triage staff inquire about the patient's general condition to preliminarily confirm the possibility of ectopic pregnancy and notify the emergency surgeon, thereby immediately activating the ectopic pregnancy alert. (2) Initial Assessment and Management: The emergency surgeon assesses the patient's general condition. The patient is moved to the resuscitation room for vital signs monitoring. (3) Subsequent Examinations: Rapid tests and examinations are performed via the green channel. (4) Subsequent Treatment: The patient is admitted to the emergency virtual ward. An obstetrics and gynecology doctor arrives on site within 10 minutes to assess the patient for subsequent treatment. A hospital-wide ectopic pregnancy green channel service system is established to ensure priority treatment for ectopic pregnancy patients across all relevant departments. In cases requiring urgent blood transfusion, the emergency surgeon or nurse can promptly notify the blood bank by phone to ensure timely transfusion. Patients with surgical indications receive priority for surgery. The obstetrics and gynecology doctor completes preoperative preparation in the resuscitation room via the virtual ward system, and the patient is transported directly from the emergency resuscitation room to the operating room within 30 minutes of admission to shorten surgical wait times. Furthermore, if patients face difficulties with medical payments, the principle of \"treat first, pay later\" applies to avoid delays in treating critically ill patients. Patients assessed as suitable for conservative treatment are transferred from the virtual ward to the obstetrics and gynecology ward for subsequent management.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec7\" class=\"Section3\"\u003e\n\u003ch2\u003e1.2.3 Emergency Protocol\u003c/h2\u003e\n\u003cp\u003e\u003cstrong\u003eTraditional Model\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTriage \u0026rarr; Reception by emergency surgeon \u0026rarr; Ordering tests \u0026rarr; Patient completes tests independently \u0026rarr; Contact Obstetrics \u0026amp; Gynecology after confirmation \u0026rarr; Transfer to ward \u0026rarr; Treatment arranged by OB/GYN doctor.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv class=\"Heading\"\u003e\u003cstrong\u003eNovel Model\u003c/strong\u003e:\u003c/div\u003e\n\u003cp\u003e(A) Admission 0 minutes: Experienced triage staff activate the alarm and initiate the MDT upon initial suspicion of ectopic pregnancy.\u003c/p\u003e\n\u003cp\u003e(B) Admission 5 minutes: Patient enters the resuscitation room. Emergency bedside ultrasound, urine pregnancy test, and blood \u0026beta;-hCG test are completed via the green channel.\u003c/p\u003e\n\u003cp\u003e(C) Admission 10 minutes: Upon confirmation, the OB/GYN doctor arrives at the resuscitation room (virtual ward) within 10 minutes. The trauma nurse monitors vital signs, and the IV access nurse establishes venous access. The emergency surgeon performs the initial assessment and provides necessary support.\u003c/p\u003e\n\u003cp\u003e(D) Admission 25 minutes: The OB/GYN doctor re-evaluates and decides the treatment plan. Patients requiring surgery complete preoperative preparation and consent discussions within the virtual ward and are transported directly to the operating room by the team. Patients eligible for conservative treatment are transferred to the OB/GYN ward.\u003c/p\u003e\n\u003cp\u003e(E) Admission 30 minutes: Patient enters the operating room. The principle of \"treatment first, payment later\" is implemented throughout the process.\u003c/p\u003e\n\u003cp\u003e(The specific flowchart is shown in Fig.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e. Differences between the two models are summarized in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.)\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDifferences Between the Traditional Care Model and the Trauma Care Model\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eItem\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTraditional Care Model\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eTrauma Care Model\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHuman Resources\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEctopic Pregnancy MDT Team\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eYes\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMedical Staff Model\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eOne-doctor, multiple-nurses model\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTwo-doctors, two-nurses model\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNurses have no clear division of responsibilities\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEach member has clearly defined responsibilities\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTraining and Assessment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMonthly training and assessment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMonthly training and assessment\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eNo team collaboration training\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTeam collaboration training is conducted\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eMethods\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEctopic Pregnancy Alert Activation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActivated only after confirmation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eActivated upon triage suspicion\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eInitial Assessment and Management\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerformed by triage staff\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003ePerformed by an emergency surgeon\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSubsequent Examinations\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRoutine emergency process\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eEmergency green channel\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eSubsequent Treatment\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTransferred to OB/GYN department first\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eDirectly to the operating room via the emergency virtual ward\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\n\u003cdiv class=\"Heading\"\u003e1.2.4 Observation Indicators\u003c/div\u003e\n\u003cp\u003eEight emergency quality control indicators were recorded and compared:\u003c/p\u003e\n\u003cp\u003e(1) Admission Time\u003c/p\u003e\n\u003cp\u003eThe time from the patient's first medical contact to being received by the emergency surgeon.\u003c/p\u003e\n\u003cp\u003e(2) Time to Establish Effective Circulatory Access\u003c/p\u003e\n\u003cp\u003eThe time from being received by the emergency surgeon to the establishment of effective circulatory access.\u003c/p\u003e\n\u003cp\u003e(3) Time to Perform Color Doppler Ultrasound\u003c/p\u003e\n\u003cp\u003eThe time from the emergency surgeon ordering the examination to the performance of the color Doppler ultrasound.\u003c/p\u003e\n\u003cp\u003e(4) Time to Obtain Urine Pregnancy Test Results\u003c/p\u003e\n\u003cp\u003eThe time from the emergency surgeon ordering the test to the issuance of the urine pregnancy test results.\u003c/p\u003e\n\u003cp\u003e(5) Time to Obtain Serum \u0026beta;-Human Chorionic Gonadotropin (\u0026beta;-hCG) Test Results\u003c/p\u003e\n\u003cp\u003eThe time from the emergency surgeon ordering the test to the issuance of the serum \u0026beta;-hCG test results.\u003c/p\u003e\n\u003cp\u003e(6) Time to Definitive Diagnosis\u003c/p\u003e\n\u003cp\u003eThe time from the patient's first medical contact to the definitive diagnosis.\u003c/p\u003e\n\u003cp\u003e(7) Time to Enter Operating Room\u003c/p\u003e\n\u003cp\u003eThe time from the definitive diagnosis of ectopic pregnancy to entering the operating room.\u003c/p\u003e\n\u003cp\u003e(8) Patient and Family Satisfaction with Emergency Care\u003c/p\u003e\n\u003cp\u003eA survey of patient and family satisfaction regarding the emergency response time, process, and success rate.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\n\u003ch2\u003e1.3 Statistical Methods\u003c/h2\u003e\n\u003cp\u003eStatistical analysis was performed using SPSS 21.0 software. Measurement data are expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (x\u0026thinsp;\u0026plusmn;\u0026thinsp;s), and intergroup comparisons were made using the t-test. Count data are expressed as number (percentage), and intergroup comparisons were made using the \u0026chi;\u0026sup2; test or Fisher's exact test. Ranked data were analyzed using the rank-sum test. A P value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"2. Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\n\u003ch2\u003e2.1 Comparison of General Patient Data Between the Two Groups\u003c/h2\u003e\n\u003cp\u003eA total of 63 patients were included. There were no statistically significant differences between the two groups in age, vital signs at admission (body temperature, heart rate, respiration, blood pressure), or length of hospital stay (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), indicating comparability. However, the total medical cost in the trauma care model group was significantly lower than that in the traditional model group (P\u0026thinsp;=\u0026thinsp;0.002), and the fallopian tube preservation rate was significantly higher in the trauma care model group (43.8% vs. 19.4%, P\u0026thinsp;=\u0026thinsp;0.034). Details are shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eGeneral Clinical Characteristics of Patients in the Traditional Care Model and the Trauma Care Model\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eTraditional Care Model (n=31)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eTrauma Care Model (n=32)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eAge (years)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e33.29 \u0026plusmn; 5.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e30.78 \u0026plusmn; 6.59\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.133\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eSurgical Approach\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.034\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Salpingostomy (Fallopian Tube Preserved)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e6 (19.4%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e14 (43.8%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Salpingectomy (Fallopian Tube Removed)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e25 (80.6%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e18 (56.3%)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eVital Signs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Body Temperature (\u0026deg;C)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e36.53 \u0026plusmn; 0.27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e36.63 \u0026plusmn; 0.28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.323\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Heart Rate (beats/min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e89.61 \u0026plusmn; 15.60\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e85.94 \u0026plusmn; 10.64\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.078\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Respiratory Rate (breaths/min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e19.03 \u0026plusmn; 1.14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e18.97 \u0026plusmn; 1.09\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.852\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Systolic Blood Pressure (mmHg)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e107.77 \u0026plusmn; 15.44\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e113.47 \u0026plusmn; 20.83\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.212\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003e*Diastolic Blood Pressure (mmHg)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e69.10 \u0026plusmn; 12.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e74.09 \u0026plusmn; 12.53\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.504\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eLength of Hospital Stay (days)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e5.10 \u0026plusmn; 2.94\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e4.88 \u0026plusmn; 1.24\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.285\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTotal Cost (RMB)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e10933.16 \u0026plusmn; 2843.31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e10068 \u0026plusmn; 1175.32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.002\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\n\u003ch2\u003e2.2 Comparison of Emergency Quality Control Indicators Between the Two Groups\u003c/h2\u003e\n\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e, the trauma care model group performed significantly better than the traditional model group on all eight time indicators (P\u0026thinsp;\u0026lt;\u0026thinsp;0.001), including admission time, time to establish effective circulatory access, time to complete various examinations and obtain results, time to definitive diagnosis, and time to enter the operating room. Simultaneously, the emergency care satisfaction score in the trauma care model group was also significantly higher than that in the traditional model group (P\u0026thinsp;=\u0026thinsp;0.013).\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eEight Emergency Quality Control Indicators for Patients in the Traditional Care Model and the Trauma Care Model\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eItem\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eTraditional Care Model\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003eTrauma Care Model\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003ep-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eAdmission Time (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e6.58 \u0026plusmn; 2.66\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e3.03 \u0026plusmn; 0.78\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Establish Effective Circulatory Access (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e53.39 \u0026plusmn; 20.49\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e12.50 \u0026plusmn; 1.65\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Perform Color Doppler Ultrasound (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e29.48 \u0026plusmn; 15.36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e7.75 \u0026plusmn; 0.98\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Obtain Urine Pregnancy Test Results (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e13.58 \u0026plusmn; 2.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e4.00 \u0026plusmn; 0.80\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Obtain Serum \u0026beta;-hCG Results (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e49.16 \u0026plusmn; 10.79\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e23.50 \u0026plusmn; 0.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Definitive Diagnosis (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e36.61 \u0026plusmn; 14.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e10.78 \u0026plusmn; 1.26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003eTime to Enter Operating Room (min)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e76.16 \u0026plusmn; 24.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e28.53 \u0026plusmn; 1.05\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.000\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003cp\u003ePatient and Family Satisfaction with Emergency Care (score)\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e90.64 \u0026plusmn; 3.86\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e96.00 \u0026plusmn; 2.58\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd\u003e\n\u003cp\u003e0.013\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003c/div\u003e"},{"header":"3. Discussion","content":"\u003cp\u003eThis study is the first to apply a structured emergency model integrating the concepts of the trauma green channel and the emergency virtual ward to the management of ectopic pregnancy. The results demonstrate that this model significantly shortens key in-hospital time points, increases the fallopian tube preservation rate, reduces medical costs, and improves patient satisfaction.\u003c/p\u003e \u003cp\u003eThe management of ectopic pregnancy is a race against time. Both domestic and international studies emphasize that the \"golden window\" from hospital admission to surgery critically impacts prognosis, particularly the preservation of fertility [16][17]. The traditional sequential, multi-department transfer process has inherent delays [18]. The novel model constructed in this study achieves process reengineering through three core initiatives: First, early warning and MDT linkage. Drawing on concepts like ACiLS for non-traumatic critical care[19][20], the alarm is activated upon triage suspicion, shifting from \"initiation after confirmation\" to \"linkage after warning,\" placing MDT consultation at the forefront of decision-making, effectively reducing communication barriers and waiting times between departments. Second, spatial and resource integration. The \"emergency virtual ward\" brings the OB/GYN doctor's consultation space forward to the resuscitation room. Combined with the green channel ensuring priority for examinations, it realizes an efficient operational model where \"the patient remains stationary, while information and doctors move,\" aligning well with the \"one-stop\" treatment concept pursued by modern emergency medicine [21][22]. Third, process standardization and team specialization. A fixed MDT team with clear division of responsibilities, supplemented by regular team collaboration training, ensures the orderliness and tacit understanding of the rescue process, consistent with the experiences reported by Zhao et al. et al.[10]and Liu and Bai [11] in trauma center construction.\u003c/p\u003e \u003cp\u003eThe observed higher fallopian tube preservation rate in the trauma care model group is likely attributable to the significantly earlier diagnosis and surgical intervention. When the ectopic pregnancy mass is treated before rupture or in the early stages of rupture, the opportunity to perform fertility-preserving surgery (such as salpingostomy) is greater[23][24]. Meanwhile, the efficiency gains from process optimization, avoiding unnecessary hospital days and related tests, likely contributed to the lower total medical cost in this group, consistent with the view that efficient healthcare models are often more cost-effective[25].\u003c/p\u003e \u003cp\u003eThis study has several limitations. First, as a single-center retrospective study, potential selection bias exists, and the generalizability of the conclusions needs further verification. Second, the relatively small sample size may affect the statistical power of some subgroup analyses. Third, a detailed cost-effectiveness analysis of the two models was not performed. Finally, data on long-term postoperative fertility outcomes (such as intrauterine pregnancy rate, recurrent ectopic pregnancy rate) are lacking.\u003c/p\u003e \u003cp\u003eFuture research directions should include: conducting multicenter, prospective randomized controlled trials to provide higher-level evidence; expanding the sample size and performing subgroup analyses for patients with different severity levels; performing comprehensive health economic evaluations; and establishing long-term follow-up mechanisms to assess the model's long-term impact on patients' fertility quality and quality of life.\u003c/p\u003e"},{"header":"4. Conclusion","content":"\u003cp\u003eThe novel trauma emergency model for ectopic pregnancy, based on the trauma green channel and the emergency virtual ward in our hospital, significantly optimized the in-hospital emergency process, shortened key time points, reduced medical costs, and helped improve the rate of fertility preservation and patient satisfaction with emergency care through multidisciplinary collaboration, process reengineering, and resource integration. It provides an efficient and referable new management model for the emergency treatment of ectopic pregnancy.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgment:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all authors who contributed valuable methods and data and made them public.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the other data supporting the findings of this study are available within the article and its Supplementary Information Files, or from the corresponding authors upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDisclosure Statement:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare the following financial interests/personal relationships which may be considered as potential competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. This work described has not been published previously and not under consideration for publication elsewhere.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Statement:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll patients’s data used was anonymized before its use. The ethics committee of Affiliated Taizhou People’s Hospital of Nanjing Medical University exempted the ethical requirements of this study, and all patients have signed informed consent forms. The present study was conducted in accordance with the ethical standards and the Declaration of Helsinki.\u0026nbsp;\u003cstrong\u003eClinical trial number: not applicable.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors Contribution:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFei Qian conceived and designed this study. Lin Sun prepared the figures, analyzed data and wrote the first version of the manuscript. Jianquan You revised the manuscript. All authors have read and approved the final manuscript.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003cp\u003e以下是按**BMC Emergency Medicine** 参考文献格式要求修改后的参考文献部分。该期刊通常要求使用**顺序编号制（citation by numbers）**，文内引用使用方括号数字如[1]，文末参考文献列表按引用顺序排列，并采用标准期刊缩写（如PubMed/NCBI格式）。\u0026nbsp;\u003c/p\u003e\n\u003col\u003e\n\u003cli\u003eFarquhar CM. Ectopic pregnancy. Lancet. 2005;366(9485):583-91.\u003c/li\u003e\n\u003cli\u003eBrim ACS, Barretto VRD, Reis-Oliveira JG, da Silveira de Ara\u0026uacute;jo RB, Romeo ACDC B. Risk factors for ectopic pregnancy occurrence: Systematic review and meta-analysis. Int J Gynaecol Obstet. 2025;168(3):919-32.\u003c/li\u003e\n\u003cli\u003eHendriks E, Rosenberg R, Prine L. Ectopic Pregnancy: Diagnosis and Management. Am Fam Physician. 2020;101(10):599-606.\u003c/li\u003e\n\u003cli\u003eBo W, Qianyu Z, Mo L. Global, Regional, and National Burden of Ectopic Pregnancy: A 30-Year Observational Database Study. Int J Clin Pract. 2023;2023:3927337.\u003c/li\u003e\n\u003cli\u003eMullany K, Minneci M, Monjazeb R, Coiado OC. Overview of ectopic pregnancy diagnosis, management, and innovation. Womens Health (Lond). 2023;19:17455057231160349.\u003c/li\u003e\n\u003cli\u003eHao HJ, Feng L, Dong LF, Zhang W, Zhao XL. Reproductive outcomes of ectopic pregnancy with conservative and surgical treatment: A systematic review and meta-analysis. Medicine (Baltimore). 2023;102(17):e33621.\u003c/li\u003e\n\u003cli\u003eCanis M, Savary D, Pouly JL, Wattiez A, Mage G. Grossesse extra-ut\u0026eacute;rine: crit\u0026egrave;res de choix du traitement m\u0026eacute;dical ou du traitement chirurgical [Ectopic pregnancy: criteria to decide between medical and conservative surgical treatment?]. J Gynecol Obstet Biol Reprod (Paris). 2003;32(7 Suppl):S54-63.\u003c/li\u003e\n\u003cli\u003eJurkovic D, Wilkinson H. Diagnosis and management of ectopic pregnancy. BMJ. 2011;342:d3397.\u003c/li\u003e\n\u003cli\u003eHoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. 2010;115(3):495-502.\u003c/li\u003e\n\u003cli\u003eZhao Q, Zhao Y, Ke T, Lin C, Xu Y, Xu Y, et al. The effect of a new in-hospital trauma care model on the outcomes of severely injured trauma patients in the emergency department: a retrospective observational study in China. BMC Emerg Med. 2025;25(1):47.\u003c/li\u003e\n\u003cli\u003eLiu T, Bai XJ. Trauma care system in China. Chin J Traumatol. 2018;21(2):80-3.\u003c/li\u003e\n\u003cli\u003eBarnhart KT. Clinical practice. Ectopic pregnancy. N Engl J Med. 2009;361(4):379-87.\u003c/li\u003e\n\u003cli\u003eRiessen R, Bulla P, Mengel A, Kumle B. Initiale Diagnostik und Therapie des Schocks [Initial diagnosis and treatment of shock]. Med Klin Intensivmed Notfmed. 2024;119(8):650-8.\u003c/li\u003e\n\u003cli\u003eDziegielewski J, Schulte FC, Jung C, Wolff G, Hannappel O, K\u0026uuml;mpers P, et al. Resuscitation room management of patients with non-traumatic critical illness in the emergency department (OBSERvE-DUS-study). BMC Emerg Med. 2023;23(1):43.\u003c/li\u003e\n\u003cli\u003eSuk F, et al. Transforming surgical care: The launch of the UK's first surgical virtual ward for acute and elective patients. Surg Endosc. 2025;39(11):7628-32.\u003c/li\u003e\n\u003cli\u003eMurray H, Baakdah H, Bardell T, Tulandi T. Diagnosis and treatment of ectopic pregnancy. CMAJ. 2005;173(8):905-12.\u003c/li\u003e\n\u003cli\u003eLipscomb GH. Medical therapy for ectopic pregnancy. Semin Reprod Med. 2007;25(2):93-8.\u003c/li\u003e\n\u003cli\u003eHajenius PJ, Mol F, Mol BW, Bossuyt PM, Ankum WM, Van der Veen F. Interventions for tubal ectopic pregnancy. Cochrane Database Syst Rev. 2007;(1):CD000324.\u003c/li\u003e\n\u003cli\u003eCondous G, Okaro E, Khalid A, Lu C, Van Huffel S, Timmerman D, et al. The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Hum Reprod. 2005;20(5):1404-9.\u003c/li\u003e\n\u003cli\u003eKirk E, Papageorghiou AT, Condous G, Tan L, Bora S, Bourne T. The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy. Hum Reprod. 2007;22(11):2824-8.\u003c/li\u003e\n\u003cli\u003eBarnhart KT, Sammel MD, Gracia CR, Chittams J, Hummel AC, Shaunik A. Risk factors for ectopic pregnancy in women with symptomatic first-trimester pregnancies. Fertil Steril. 2006;86(1):36-43.\u003c/li\u003e\n\u003cli\u003eAnkum WM, Mol BW, Van der Veen F, Bossuyt PM. Risk factors for ectopic pregnancy: a meta-analysis. Fertil Steril. 1996;65(6):1093-9.\u003c/li\u003e\n\u003cli\u003eStovall TG, Ling FW. Ectopic pregnancy: diagnostic and therapeutic algorithms minimizing surgical intervention. J Reprod Med. 1993;38(10):807-12.\u003c/li\u003e\n\u003cli\u003eCohen A, Zakar L, Gil Y, Amer-Alshiek J, Amir H, Bilgory A, et al. Methotrexate success rates in progressing ectopic pregnancies: a retrospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2014;183:81-4.\u003c/li\u003e\n\u003cli\u003eLipscomb GH, Stovall TG, Ling FW. Nonsurgical treatment of ectopic pregnancy. N Engl J Med. 2000;343(18):1325-9.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Ectopic Pregnancy, Trauma Care Model, Green Channel, Virtual Ward, Emergency Process, Multidisciplinary Team (MDT)","lastPublishedDoi":"10.21203/rs.3.rs-8547410/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8547410/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEctopic pregnancy is a common gynecological emergency with a rapid onset, posing a serious threat to the life and health of women of reproductive age. Its incidence is increasing globally, and early diagnosis and timely intervention are crucial for reducing mortality and preserving fertility. This study aims to investigate the role of a novel emergency model based on the trauma green channel and an emergency virtual ward in improving the treatment efficiency for patients with ectopic pregnancy.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA retrospective study was conducted on 63 ectopic pregnancy patients who underwent emergency surgery in our hospital between January 2023 and April 2025. They were divided into a traditional model group (31 cases) and a trauma care model group (32 cases). General clinical data and eight emergency quality control indicators were collected and compared, including patient admission time, time to establish effective circulatory access, time to perform color Doppler ultrasound, time to obtain urine pregnancy test results, time to obtain serum β-hCG results, time to definitive diagnosis, time to enter the operating room, and satisfaction score with emergency care.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eNo significant differences were found between the two groups in terms of age, vital signs, or length of hospital stay (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The trauma care model group had significantly lower total medical costs (P\u0026thinsp;=\u0026thinsp;0.002) and a higher rate of fallopian tube preservation (43.8% vs. 19.4%, P\u0026thinsp;=\u0026thinsp;0.034) compared to the traditional model group. Furthermore, the trauma care model group demonstrated significantly better results in all eight emergency quality control indicators (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and patient and family satisfaction with the emergency process was also significantly higher (P\u0026thinsp;=\u0026thinsp;0.013).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThe novel trauma emergency model for ectopic pregnancy, based on the trauma green channel and the emergency virtual ward, significantly optimized the emergency process, shortened key time points, reduced medical costs, and helped improve the rate of fertility preservation and patient satisfaction with emergency care. It demonstrates good value for clinical application and promotion.\u003c/p\u003e","manuscriptTitle":"A Novel Model Based on the Trauma Green Channel and Emergency Virtual Ward Improves the Efficiency of the Emergency Process for Ectopic Pregnancy Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-11 16:56:44","doi":"10.21203/rs.3.rs-8547410/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"695aa531-00e7-4625-b321-934622cc22a5","owner":[],"postedDate":"February 11th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T09:41:59+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-11 16:56:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8547410","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8547410","identity":"rs-8547410","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}