开普敦急诊中心的急性血管和建议的算法,以简化和改进管理
C Day1, J Van der Walt2, K Crombie3
1Division of Allergology and Clinical Immunology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Allergy and Immunology Unit, University of Cape Town Lung Institute, Cape Town, South Africa. cascia.day@uct.ac.za.
概括
急性血管是常见的紧急情况,通常是由ACE抑制剂引起的. 许多病例的管理不善,突出了需要新的诊断和治疗算法,以改善患者的治疗结果.
科学领域:
- 紧急医疗 紧急医疗
- 过敏和免疫学 过敏和免疫学
- 药理学 药理学是指药理学的学科.
背景情况:
- 血管是急诊中心最常见的急性过敏表现,全球住院病例增加.
- 危及生命的喉阻塞是血管的潜在并发症.
- 南非缺乏关于血管的表现和管理的当地数据.
研究的目的:
- 描述南非急诊中心急性血管瘤病例的临床表现,管理和结果.
- 开发一个简单的管理算法急性血管适合南非的背景.
主要方法:
- 从2018年6月到2020年6月,对在开普敦两家急诊中心出现血管的成年患者进行了回顾性审查.
- 数据提取包括人口统计,病史,管理和结果,使用ICD-10编码进行患者识别.
- 一位过敏学家检查了患者档案,以收集与血管相关的特定信息.
主要成果:
- 分析了142次血管发作;14%涉及呼吸道损害,其中2次需要输管.
- 药物诱导的血管是最常见的 (45%),主要与ACE抑制剂有关 (65.6%的药物诱导病例).
- 关键信息的不充分记录 (64.7%的过敏史) 和不适当的治疗 (36%的皮质类固醇/抗胰岛素用于布拉迪基宁介导的血管) 被注意到. 只有25%的人被转介到过敏护理.
结论:
- 血管是开普敦的一个重大紧急情况,而 ACE 抑制剂诱导的布拉迪基宁介导血管是最常见的原因.
- 很大一部分布拉迪基宁介导的血管发病例的管理不当.
- 开发了一个新的管理算法来分层患者和指导治疗,强调需要提高意识和专家转诊.
相关概念视频
Cardiopulmonary Resuscitation IV: Pharmacological Management
12
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
12
Cardiopulmonary Resuscitation II: ACLS Airway Management
16
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
16
Acute Coronary Syndrome V: Nursing Management
16
Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
16
Acute Coronary Syndrome IV: Interprofessional Care
11
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
11
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8
Heart Failure V: Medical Management
9
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
9


