在急诊室的狂犬病暴露后预防
Terese Lewis1, Krysta Baack1, Leigh Gomez1
1Department of Pharmaceutical and Nutrition Care, The Nebraska Medical Center, Omaha, NE 68198, USA.
The American journal of emergency medicine
|February 8, 2024
概括
这项研究比较了两个医疗机构之间的狂犬病疫苗完成率,发现整体遵守率为78.3%. 内布拉斯加州医学医疗中心的完成率高于贝尔维尤医疗中心,并确定了潜在的成本节约.
科学领域:
- 公共卫生和流行病学
- 传染性疾病 传染性疾病
- 疫苗学 疫苗学 疫苗学
背景情况:
- 狂犬病是一种致命的动物性病毒性疾病,需要及时的暴露后预防 (PEP).
- PEP涉及狂犬病免疫球蛋白 (RIG) 和疫苗接种系列,其遵守对疗效至关重要.
- 不同的医疗保健机构可能有不同的协议来完成狂犬病疫苗系列.
研究的目的:
- 为了比较患者遵守两种不同的狂犬病疫苗接种系列完成的随访协议.
- 为了确定内布拉斯加州医学医疗中心 (NMC) 和贝尔维尤医疗中心 (BMC) 之间的合规率差异.
- 探索影响合规性和RIG剂量圆的潜在成本节约的因素.
主要方法:
- 2019年7月至2022年6月期间接受狂犬病PEP的18岁以上患者的回顾性图表审查.
- 从电子医疗记录 (EMR) 通过SQL查询和手动审查抽取的数据.
- 分析包括描述性统计数据,以比较完成率并确定影响因素.
主要成果:
- 在143名独特患者中,狂犬病疫苗系列的整体适当完成率为78.3%.
- 与贝尔维尤医疗中心 (BMC) (69%) 相比,内布拉斯加州医学医疗中心 (NMC) 的完成率更高 (82%),尽管在统计学上并不显著.
- 根据付款人和风险类型观察到完成的显著差异;通过RIG剂量圆形化确定了57928.64美元的潜在成本节省.
结论:
- 患者对狂犬病疫苗接种系列的遵守程度因医疗机构和协议而异.
- 优化日程安排和考虑RIG剂量圆形化可以改善坚持并降低成本.
- 对影响合规性的患者特异性因素进行进一步调查是有必要的.
更多相关视频
07:40Field Postmortem Rabies Rapid Immunochromatographic Diagnostic Test for Resource-Limited Settings with Further Molecular Applications
Published on: June 29, 2020
13.4K
07:54Author Spotlight: Rabies-Specific Antibody Isotypes Detection in Sera or Cerebral Spinal Fluid Using an IFA Test
Published on: January 19, 2024
2.2K
相关概念视频
01:26Pharmaceutical Poisoning: Treatment Strategies
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
01:26Rocky Mountain Spotted Fever
Rocky Mountain Spotted Fever (RMSF) is a severe tick-borne illness caused by Rickettsia rickettsii, a Gram-negative, coccobacillary bacterium. This pathogen is an obligate intracellular parasite, requiring a host cell for replication. Transmission occurs through the bite of an infected tick. In the United States, the most important vectors are Dermacentor variabilis (American dog tick) and Dermacentor andersoni (Rocky Mountain wood tick), though other tick species may also serve as vectors.
01:28Diphtheria
Diphtheria is an acute, toxin-mediated infectious disease that primarily affects the upper respiratory tract. It is caused by Corynebacterium diphtheriae, a Gram-positive, pleomorphic rod that lacks spore-forming capability and exhibits a characteristic club-shaped morphology under microscopic examination. While C. diphtheriae can asymptomatically colonize mucosal surfaces, clinical disease manifests only when the bacterial strain is lysogenized by a specific β-corynephage. This phage...
01:28Rabies
Rabies is a lethal zoonotic disease caused by a single-stranded, negative-sense RNA virus of the Lyssavirus genus, within the family Rhabdoviridae. Its primary mode of transmission to humans is through bites or saliva-contaminated scratches from infected mammals such as dogs, bats, raccoons, or foxes. Transmission can also occur if infectious saliva contacts abraded skin or intact mucous membranes, including the conjunctiva.Viral Entry and Early ReplicationOnce introduced at the bite or scratch...