低收入和中等收入国家的医院前出血管理:一个范围审查
Ashwin J Kulkarni1,2,3, Amber Batra2,4, Zachary J Eisner1,2,3
1University of Michigan Medical School, Ann Arbor, Michigan, USA.
World journal of surgery
|January 24, 2024
概括
低收入和中等收入国家 (LMICs) 的急救人员的出血管理 (HM) 培训显示了显著的知识改进. 优先考虑HM资源对于减少这些地区的伤害死亡至关重要.
科学领域:
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
- 全球健康 全球健康
背景情况:
- 低收入和中等收入国家 (LMICs) 承担了不成比例的受伤相关死亡负担,出血占了很大一部分.
- 在LMICs的医院前护理往往不足,严重出血导致的死亡率加剧.
- 有效的出血管理 (HM) 是LMICs医院前护理的关键,但尚未总结的组成部分.
研究的目的:
- 对LMIC中医院前出血管理 (HM) 实践的当前文献进行审查.
- 评估LMIC中第一响应者HM培训计划的影响和结果.
主要方法:
- 使用PMC,MEDLINE和Scopus数据库 (2000年1月至2023年1月) 进行了一项系统的文献审查.
- 在物品的识别和选择中遵循了PRISMA-ScR指南.
- 纳入标准侧重于医院前医疗保健的第一响应者培训计划,使用纽卡斯尔-太华规模评估质量.
主要成果:
- 来自16个国家的20项研究符合纳入标准,包括各种研究设计.
- 基本的HM课程出现在15个研究中,高级课程出现在6个研究中.
- 首次响应者报告说,在55%-76%的遭遇中使用了HM技能,在诸如轮应用后培训等技术中获得了显著的知识增长 (23-58个百分点).
结论:
- 本综述综合了LMIC中医院前HM的现有证据,涵盖流行病学,干预措施和结果.
- 显然需要优先考虑和进一步发展出血管理资源和为LMIC的首次响应人员提供培训.
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