紧急医疗服务人员遵守升级气道算法协议
Annals of family medicine
|January 25, 2024
概括
紧急医疗服务 (EMS) 人员经常偏离先进的气道管理协议,通常首先选择侵入性技术. "脏的呼吸道"是这些协议偏差的主要原因.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 医疗保健服务研究 医疗服务研究
背景情况:
- 先进的气道管理在紧急医疗服务 (EMS) 中至关重要.
- 协议通常要求采取分阶段的方法,从少入侵的技术开始.
- 遵守这些协议对于患者的氧化和通风至关重要.
研究的目的:
- 评估EMS人员是否遵守先进的气道管理协议.
- 在这些干预期间评估氧化和通风的有效性.
- 确定气道管理中协议偏差的原因.
主要方法:
- 在威奇塔/塞德威克县EMS系统 (2017年) 中对先进的气道管理病例的回顾性图表审查.
- 分析非识别数据,以确定使用的气道管理技术的顺序.
- 使用科恩的卡帕系数 (κ) 和浸泡结晶方法进行统计分析.
主要成果:
- 在279个高级气道管理病例中,90%的人没有遵循协议序列.
- 在80%的病例中,最具侵入性的技术被使用,而不是先尝试少入侵的方法.
- "脏的呼吸道"是使用更具侵入性的技术的最常见理由.
结论:
- 塞德威克县/威奇塔的急救服务人员经常偏离已建立的先进的气道管理协议.
- "脏气道"的存在是影响偏差的一个重要因素.
- 了解这些偏差背后的原因对于改善培训,方案和患者的治疗结果至关重要.
相关概念视频
Administering Oxygen by Mask
359
Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
359
Tracheostomy Care II: Procedure
186
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...
186
Assessment of Airway, Skin Color, and Use of Accessory Muscles
1.0K
A thorough assessment of respiratory health is paramount in clinical settings to identify and manage respiratory distress and ensure adequate oxygenation. This article elaborates on the critical aspects of respiratory evaluation, including airway assessment, skin color examination, and the observation of accessory muscle use, which are integral to effectively diagnosing and managing patients with respiratory conditions.
Introduction
The initial evaluation of a patient's respiratory system...
Introduction
The initial evaluation of a patient's respiratory system...
1.0K
Acute Respiratory Failure-V
140
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
140
Tracheostomy Care I: Pre-procedural Steps
188
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:
188
Tracheostomy Suctioning I: Pre-Procedural Steps
554
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...
554


