开发一种基于共识的医院外临床恶化的定义:德尔菲研究
Emma Bourke-Matas1, Emma Bosley2, Karen Smith3
1Department of Paramedicine, School of Primary and Allied Health Care, Monash University, McMahons Rd, Frankston, Victoria, 3199, Australia; Queensland Ambulance Service, Department of Health, Emergency Services Complex, Cnr Park and Kedron Park Rds, Kedron, Queensland, 4031, Australia.
概括
紧急医疗专业人员建立了医院外 (OOH) 临床恶化的共识定义. 这种定义有助于开发早期预警系统,以便及时干预并改善患者的治疗结果.
科学领域:
- 紧急医疗 紧急医疗
- 在医院前的护理.
- 临床评估 临床评估
背景情况:
- 临床恶化是一个关键的紧急情况,需要立即识别和干预.
- 医院外 (OOH) 环境为管理病情恶化的患者带来了独特的挑战.
- 目前在医学文献中缺乏OOH临床恶化的标准化定义.
研究的目的:
- 建立基于共识的OOH临床恶化的定义.
- 让紧急医疗卫生专业人员参与OOH临床恶化的定义.
主要方法:
- 从2020年6月到2021年1月,通过电子方式进行了三轮的Delphi研究.
- 一个由30名临床医生组成的专家小组参加了会议,包括急诊医生和护理人员.
主要成果:
- 一个共识定义将OOH临床恶化定义为与基线相比生理状态的恶化,由生命体征变化和症状表明.
- 怀疑的关键生命体征包括呼吸速率,心率,血压,格拉斯哥昏迷表,氧和度,心电图和皮肤颜色.
- 92%的参与者同意,早期预警系统将有利于及时识别.
结论:
- 达成共识的定义为开发和验证OOH特定的早期预警系统提供了基础.
- 标准化使得医疗保健服务之间能够进行一致的研究和有意义的比较.
- 需要进一步的研究,以提高对OOH临床恶化的理解和及时干预,减少发病率和死亡率.
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