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临床触发因素和影响危机确认和呼吁麻醉科医生的帮助的生命体征:基于模拟的观察性研究
Lukas H Matern1, Roxane Gardner2, Jenny W Rudolph3
1Clinical Fellow in Critical Care Medicine, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.
Journal of clinical anesthesia
|August 26, 2023
概括
麻醉科医生在模拟过敏反应期间在65mmHg的平均动脉压下识别出危机. 危机确认时间有所不同,一些临床医生发现危机迟到了,可能会危及患者的安全.
科学领域:
- 麻醉学 麻醉学
- 医疗模拟 医疗模拟
- 患者安全 患者安全
背景情况:
- 对于麻醉科医生来说,及时确认危机至关重要,以防止在外科手术期间的紧急情况中伤害患者.
- 了解危机识别的触发因素对于改善患者治疗结果至关重要.
研究的目的:
- 识别促使麻醉科医生承认危机的生命体征和定性因素.
- 在模拟环境中,将主管初级麻醉师 (PAIC) 和麻醉师观察员 (AO) 之间的危机确认进行比较.
主要方法:
- 一项基于模拟的前性观察研究与60名临床麻醉科医生进行.
- 参与者管理模拟的外科手术期间过敏反应,通过呼吁援助来确认危机.
- 调查人员分析了模拟录像,以确定危机确认时的生命体征和行为.
主要成果:
- 临床医生在平均动脉压 (MAP) 为65mmHg和氧和率为94%时承认危机.
- PAICs承认危机的呼吸速率高于AO (20对18次呼吸/分钟).
- 近一半的参与者在MAP <65 mmHg时发现了危机,确认时间差异很大.
结论:
- 麻醉师通常根据标准的低血压定义承认危机,活跃参与者和观察者之间的差异很小.
- 一些临床医生迟迟地发现危机,这突显了失败救援事件的风险.
- 危机管理培训应强调请求援助的触发因素.
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