【医院突发事件的处理——问题与管理】

Anaesthesiologie und Reanimation Pub Date : 2003-01-01
A Sablotzki, S Schubert, C Kuhn, J Radke, E Czeslick
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引用次数: 0

摘要

由于高危患者数量的增加、老年患者比例的增加以及外科和侵入性诊断程序的扩大,医院的医务人员面临着越来越多的紧急情况。近50%是由心脏循环引起的,发生在手术期间或手术后。危及生命的并发症的另一个原因是口服或静脉注射药物的副作用,特别是在用抗生素、麻醉剂、止痛药和镇静剂治疗后。由于大多数医院缺乏急救培训和管理,普通病房心肺复苏后的存活率仅为2%至35%。因此,似乎有必要定期对所有医务人员进行心肺复苏术程序和紧急情况管理方面的特殊培训。此外,必须建立在紧急情况下提供充分治疗的特殊基础设施(急救队、紧急电话号码、医院内急救车)。本综述的第二部分介绍了目前最常见的紧急情况的诊断和治疗策略,如过敏反应、心肌梗死、肺栓塞、胃肠道出血和肝素诱导的血小板减少症(HIT)。
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[Treatment of emergencies in the hospital--problems and management].

Due to the growing number of high-risk patients, the increasing proportion of geriatric patients and the expansion of surgical and invasive-diagnostic procedures, medical stuff in hospitals are confronted with a rising number of emergency situations. Nearly 50% are of cardio-circulatory origin and occur during surgical interventions or immediately afterwards. Another cause of life-threatening complications are side-effects of orally or intravenously administered agents, especially after treatment with antibiotics, anaesthetics, analgetics and sedatives. Due to a lack of emergency training and management in most hospitals, the survival rate after cardiopulmonary resuscitation in general wards lies between just two and 35%. Thus it seems necessary to perform special training in CPR procedures and emergency management at regular intervals for the entire medical stuff. In addition, a special infrastructure for giving sufficient treatment in emergencies has to be established (emergency team, emergency telephone number, intra-hospital emergency car). The second part of this review presents current diagnostic and therapeutic strategies for the most common emergency situations, e.g. anaphylaxis, myocardial infarction, pulmonary embolism, gastrointestinal bleeding, and heparin-induced thrombocytopenia (HIT).

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