对南非市区急诊科成年患者骨内通道使用的评价

IF 1.4 4区 医学 Q3 EMERGENCY MEDICINE African Journal of Emergency Medicine Pub Date : 2024-12-06 DOI:10.1016/j.afjem.2024.11.001
Keabetsoe Hlanze , Kylen Swartzberg , Mike Wells
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引用次数: 0

摘要

背景:及时的血管通路是急诊科病人管理的必要组成部分。低血压、静脉吸毒、肥胖、皮肤黝黑、患者年龄偏大、患者多处受伤等因素可能使外周静脉插管变得困难。骨内路径仍然是紧急循环通道的合适选择。本研究的目的是描述急诊科医生对危重成人患者使用骨内通路的知识、态度和实践。方法:对南非豪登省四家医院的急诊科进行描述性研究。问卷分发予在急诊科工作的医生,包括实习医生、社区服务医生、急诊科医务主任、急诊科医学注册主任及急诊科医学顾问。结果:在88名参与者中,64.8%的参与者从未在急诊复苏中对成年患者使用过骨内通路。那些使用骨内通路的参与者,每个临床医生每月使用1.5次。不使用骨内通路的原因包括:缺乏设备可用性,缺乏经验,以及其他较好的方法。结论:采用骨内路径进行循环通路具有可靠、易于教学、使用快捷、并发症发生率低等优点。尽管在各种课程中获得了足够的骨内通路知识和培训;提供者偏好和其他系统性障碍导致临床环境中使用骨内通道的总体减少。骨内通道仍然是获得循环通道的一种成本效益高、挽救生命的技术。这些结果可用于提高人们对获得循环利用的其他替代办法的认识,加强教育和培训,并提高保健标准,特别是在资源有限的环境中。
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Evaluation of the use of intraosseous access on adult patients presenting to the emergency department in urban South Africa

Background

Timely vascular access forms a necessary part of patient management in the Emergency Department (ED). Factors such as hypotension, intravenous drug use, obesity, dark skin, patients at extremes of age, and patients with multiple injuries may make peripheral intravenous cannulation difficult. The intraosseous route remains a suitable alternative for emergency circulatory access. The objectives of this study were to describe the knowledge, attitudes, and practice of doctors in the ED about the use of intraosseous access in critically ill adult patients.

Methods

A descriptive study was performed in the EDs of four hospitals in Gauteng, South Africa. Questionnaires were distributed to doctors working in the ED, including intern medical doctors, community service medical doctors, emergency medicine medical officers, emergency medicine registrars, as well as emergency medicine consultants.

Results

Of 88 participants 64.8 % of participants had never used intraosseous access on adult patients in a resuscitation in the ED. Those who do use intraosseous access, use it 1.5 times a month, per clinician. Reasons for not using intraosseous access included: lack of equipment availability, lack of experience, and other preferable methods.

Conclusion

The advantages of using the intraosseous route for circulatory access include its reliability, ease of teaching, rapid use, and low complication rates. Despite sufficient knowledge of intraosseous access and training received at various courses; provider preference and other systemic barriers, lead to an overall reduction in intraosseous access being used in the clinical setting. Intraosseous access remains a cost-effective, life-saving technique for gaining circulatory access. These results can be used to create awareness regarding the availability of other alternatives for gaining circulatory access, enhancing education and training, and improve the standard of health care, particularly in resource-limited settings.
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来源期刊
CiteScore
2.40
自引率
7.70%
发文量
78
审稿时长
85 days
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