对于腰部疼痛的老年人来说,紧急介绍:日益增长的临床和经济挑战
Rod Ellem1, Rowan Pickering2, Darryn Marks1,2
1Gold Coast Hospital and Health Service, Southport, Queensland, Australia.
Australasian journal on ageing
|October 6, 2023
概括
患有腰部疼痛 (LBP) 的老年人越来越多地出现在急诊室 (ED),造成更高的成本和资源使用. 个性化管理对于这一群体来说至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 老年病的医生 老年病的医生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 腰部疼痛 (LBP) 是急诊室 (ED) 访问的常见原因之一.
- 在LBP管理和结果中与年龄相关的差异尚未完全理解.
研究的目的:
- 为了比较管理,医疗保健资源利用和老年人与澳大利亚EDS的年轻成年人的LBP演示的成本.
主要方法:
- 从2015年1月到2021年7月,对11,098例成年LBP ED病例进行了回顾性分析.
- 65岁以上和65岁以下的患者之间的管理策略,调查,入院率和成本的比较.
- 多变量后勤回归以确定住院患者入院的预测因素和年龄的影响.
主要成果:
- 年长的成年人 (≥65岁) 占LBP病例的23%,趋势越来越强.
- 65岁以上的患者入院率较高 (27%),CT成像使用率增加了三倍 (24%vs. 6%),平均成本增加了一倍 (澳大利亚3973美元vs. 1671美元).
- 咨询ED理疗师与降低入院风险 (OR 0.52) 有关.
结论:
- 老年人不成比例地代表了LBP ED访问的增加,这与医疗保健成本和资源需求的增加有关.
- 不同的临床和经济特征需要针对老年LBP患者量身定制的管理策略.
- 证据支持对老年LBP患者提供ED的个性化护理建议.
相关概念视频
01:27Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
01:30Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
01:20Angina V: Nursing Management
18
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
18
01:30Heart Failure VII: Nursing Interventions
86
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
86
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
654
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
654
01:14SBAR II: Application of SBAR
4.5K
SBAR is an effective communication tool used by healthcare professionals to communicate patient information accurately. SBAR stands for Situation, Background, Assessment, and Recommendation. For a better understanding, an example is given below.
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
SBAR Report from a Nurse to a Health Care Provider
S: "Hello, Dr. Smith. This is Jane, RN, from the Med Surg unit. I am calling to tell you about Ms. White in Room 210, who is experiencing increased pain and redness at her incision site. Her recent...
4.5K