青少年创伤患者与孤立的头部创伤和格拉斯哥昏迷尺度6-8:常规输管?
Flora S Park1, Jeffry Nahmias1, Sebastian Schubl1
1Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, University of California, Irvine School of Medicine, Orange, CA, USA.
The American surgeon
|November 20, 2023
概括
对头部创伤和格拉斯哥昏迷表 (GCS) 低分的青少年进行常规输管治疗不会增加死亡风险或停留时间. 最初的GCS得分可以指导这个人群的输管决策.
科学领域:
- 创伤外科 手术 创伤外科
- 儿科重症监护 儿科重症监护
- 紧急医疗 紧急医疗
背景情况:
- 成年人研究表明,对于压抑格拉斯哥昏迷尺度 (GCS) 的孤立头部创伤,常规输管增加了发病率和死亡率.
- 在青少年创伤患者中这种做法的结果仍未得到充分研究.
研究的目的:
- 调查青少年创伤患者到达时输管是否与死亡风险增加和长时间停留 (LOS) 相关.
主要方法:
- 对2017-2019创伤质量改善计划 (TQIP) 数据库的分析.
- 包括青少年 (12-16岁) 患有孤立的头创伤和GCS 6-8.
- 用多变量逻辑回归来比较一小时内输入管的患者与未输入管的患者之间的结局.
主要成果:
- 在141名患者中,73人 (51.8%) 在抵达时被输入管道,并发症率低 (5.6%).
- 在输入管和非输入管组之间,死亡风险 (6.8%与1.5%,P = .11) 或住院中位数长度 (2天与2天,P = .13) 没有显著差异.
- 输管与死亡率的增加没有关联 (OR1.84,P = .71).
结论:
- 患有孤立头部创伤和抑郁的GCS的青少年表现出类似的结果,无论立即输管.
- 在这个患者群体中,使用初始GCS得分来指导输管决策似乎是一种安全有效的做法.
相关概念视频
Endotracheal Intubation I: Procedure
1.5K
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
1.5K
Endotracheal Intubation II: Nursing Management
710
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
710
Endotracheal Tube Extubation
749
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
749
Tracheostomy Care I: Pre-procedural Steps
200
A tracheostomy is a surgical technique that involves making an incision in the neck to provide access to the trachea. It is frequently used in medical conditions such as airway obstruction and prolonged mechanical ventilation. Effective nursing management is crucial for the long-term success of a tracheostomy.
Required Equipment
The equipment necessary for tracheostomy care includes:
Required Equipment
The equipment necessary for tracheostomy care includes:
200
Tracheostomy Care II: Procedure
201
Tracheostomy care is an essential nursing skill that involves cleaning and maintaining a tracheostomy tube to prevent infection and other complications. Here's a step-by-step guide explaining each procedure with its rationale. Note that disposable gloves are to be worn at all times and changed as often as needed to maintain a sterile work environment, and to protect both patient and healthcare worker.
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
Step 1: Perform hand hygiene, and put on personal protective equipment: gown, gloves, mask...
201
Tracheostomy Suctioning I: Pre-Procedural Steps
585
Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
Equipment Required
First, gather all necessary equipment: a sterile suction catheter, a sterile disposable container, sterile gloves, a towel or...
585


