数据正在驱动我们的救护车吗? 在医院预先设置中自由使用特兰克萨姆酸
Alexandra M P Brito1, Gregory Stettler2, Madeline R Fram2
1Atrium Wake Forest Baptist Medical Center, The Queen's Medical Center, Oregon Health & Science University, Honolulu, HI, USA.
The American surgeon
|October 20, 2023
概括
特兰胺酸 (TXA) 被应急医疗服务 (EMS) 广泛用于创伤,但一项研究发现,它通常在基于证据的指示之外使用,这表明在医院前环境中过度使用.
科学领域:
- 创伤护理 创伤护理
- 紧急医疗 紧急医疗
- 药理学 药理学是指药理学的学科.
背景情况:
- 目前的证据支持在严重的出血性休克中早期使用特兰胺酸 (TXA).
- 协议和常务命令促进了紧急医疗服务 (EMS) 的TXA使用.
- 这项研究检查了在服务于一级创伤中心的EMS机构中TXA使用模式.
研究的目的:
- 为了调查TXA通过EMS的管理模式.
- 根据数据驱动的指示来确定医院前TXA使用的适当性.
- 测试TXA经常在基于证据的指导方针之外使用的假设.
主要方法:
- 对接受TXA的患者进行了创伤登记查询.
- 对406名EMS启动的TXA.患者的医院前和医院生理数据以及干预措施进行了检查.
- 在20多个EMS系统中调查了实践.
主要成果:
- 在2016-2021年期间,1089名TXA接受者的37.3%接受了EMS启动的治疗.
- 平均医院前静脉压 (SBP) 为108.2mmHg;只有14.6%的人达到TXA的SBP指示.
- 只有58.4%的这些患者在抵达后接受了输血.
结论:
- 特兰胺酸 (TXA) 的使用在创伤护理中很常见,并且被许多EMS系统采用.
- 医院前的TXA管理似乎被过度使用.
- 药物的使用并不总是局限于由先前数据支持的适应症.
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