医院前气道管理的基于证据的指导方针:方法和资源文件
Christopher B Gage1,2, Jonathan R Powell1,2, Nicole Bosson3
1National Registry of Emergency Medical Technicians, Columbus, Ohio.
Prehospital emergency care
|December 22, 2023
概括
新的基于证据的指导方针 (EBG) 紧急气道管理使用严格的方法开发. 这些指南帮助EMS临床医生在医院前做出决策,并发布了16条有条件的建议.
科学领域:
- 紧急医疗 紧急医疗
- 在医院前的护理.
- 临床指南开发 临床指南开发
背景情况:
- 紧急气道管理是EMS临床医生关键的医院前程序.
- 现有的决策流程需要更新,基于证据的指导.
- 开发新的基于证据的指导方针 (EBG) 对于改善医院前的气道管理至关重要.
研究的目的:
- 描述用于制定新的基于证据的指导方针 (EBG) 的方法,用于医院前紧急气道管理.
- 概述基于当前证据制订建议的系统方法.
- 为EMS提供者详细说明将证据转化为可操作的临床指南的过程.
主要方法:
- 从先前的系统审查中利用了四个关键问题来制定22个人口,干预,比较和结果 (PICO) 问题.
- 采用推,评估,开发和评估 (GRADE) 框架来评估证据并生成结论表的结论表.
- 进行了严格的系统方法,包括技术专家小组,异步评判和在线讨论,以创建证据决策表和最终基于共识的建议.
主要成果:
- 在2022年9月至2023年4月期间,生成了17个结论表和16个判断表.
- 对于大多数建议,证据的整体确定性被评为"非常低"或"低".
- 发布了16个"有条件建议",其中6个PICO问题缺乏足够的证据来制定指南. 可行性评价很好,但成本效益和公平性数据有限.
结论:
- 开发的EBG用于医院前的气道管理使用了验证的技术,如GRADE方法和系统的共识建设.
- 该过程确保了透明度,并减轻了沟通混因素,允许对PICO问题进行一致的评估.
- 这种严格的证据评估和推开发方法可以为未来的紧急医疗指南制定提供信息.
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