制定国家医院外输血协议:修改后的兰德德尔菲研究
Johannes von Vopelius-Feldt1, Joel Lockwood2, Sameer Mal2
1Ornge (von Vopelius-Feldt, Lockwood, Mal, Peddle, Smith, Nolan), Mississauga, Ont.; Department of Emergency Medicine (von Vopelius-Feldt, Lockwood, Nolan), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Division of Emergency Medicine (Mal, Peddle), London Health Sciences Centre, London, Ont.; Department of Surgery, Trauma and Acute Care Surgery (Beckett), St. Michael's Hospital, Unity Health Toronto, Toronto, Ont.; Canadian Forces Health Services Headquarters (Beckett, Schmid), Canadian Armed Forces, Ottawa, Ont.; Department of Pathology and Molecular Medicine (Callum), Kingston Health Sciences Centre and Queen's University, Kingston, Ont.; University of Toronto Quality in Utilization, Education and Safety in Transfusion (QUEST) research program (Callum, Khandelwal, Pavenski), Toronto, Ont.; AirEvac and Critical Care Operations (Greene, Vu), British Columbia Emergency Health Services, Vancouver, BC; School of Medicine (Greene), Cardiff University, Cardiff, Wales, UK; Division of Trauma and General Surgery (Grushka), McGill University Health Centre, Montreal General Hospital Site, Montréal, Que.; Canadian Blood Services (Khandelwal); Department of Laboratory Medicine and Pathobiology (Lin), University of Toronto; Precision Diagnostics and Therapeutics Program (Lin), Sunnybrook Health Sciences Centre, Toronto, Ont.; Faculty of Medicine (Nahirniak), University of Alberta, Edmonton, Alta.; Transfusion and Transplantation Medicine (Nahirniak), Alberta Precision Laboratories, Calgary, Alta.; Departments of Medicine and Laboratory Medicine (Pavenski), St. Michael's Hospital, Unity Health Toronto and University of Toronto, Toronto, Ont.; Division of Transfusion Medicine (Prokopchuk-Gauk), Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority; College of Medicine (Prokopchuk-Gauk), University of Saskatchewan, Saskatoon, Sask.; Emergency Department (Regehr), Health Sciences Centre; Shock Trauma Air Rescue Service (STARS) (Regehr), Manitoba Base, Winnipeg, Man.; Department of Pathology and Laboratory Medicine (Shih), Vancouver Coastal Health Authority; Centre for Blood Research (Shih), University of British Columbia; Department of Emergency Medicine (Trojanowski), Vancouver General Hospital and the University of British Columbia; Clinical Operations (Trojanowski), British Columbia Emergency Health Services; Departments of Emergency Medicine and Critical Care Medicine (Vu), Vancouver Coastal Health Authority and Provincial Health Services Authority, Vancouver, BC; Department of Surgery and Section of Critical Care (Ziesmann), Health Sciences Centre, Winnipeg, Man. jvopelius@ornge.ca.
医院外输血 (OHT) 计划正在为创伤和医疗患者开发. 这项研究为加拿大重症监护运输组织提供了专家共识指导,以制定安全有效的OHT协议.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理运输 运输 关键的护理
- 输血医学 输血医学
背景情况:
- 用血液制品进行早期复苏对于被选中的创伤和医疗患者至关重要.
- 医院外输血 (OHT) 计划正在出现,但基于有限的证据.
- 在重症监护运输中开发OHT协议需要指导.
研究的目的:
- 为加拿大重症监护运输组织提供专家共识指导.
- 为制定标准化的医院外输血协议提供信息.
- 建立医院前血液产品管理的最佳实践.
主要方法:
- 为了达到专家的共识,使用了经过修改的RAND Delphi过程.
- 17名学科专家参加了三个共识轮 (两个书面调查,一个虚拟小组).
- 共识被定义为至少7分之6的利克特等级中位数.
主要成果:
- 专家们同意了39个共识声明.
- 声明涵盖临床治理,血液制品管理,输血启动和监测.
- 具体的指导包括对静血附带和复苏目标的指示.
结论:
- 这份专家共识文件为OHT提供了实际指导.
- 达成共识的声明旨在支持高效和安全的医院外输血.
- 本指南适用于国家和国际重症监护运输计划.
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