在急诊室管理 Delirium:一个更新的叙事审查.
April Ehrlich1, Esther S Oh1,2,3,4, Shaista Ahmed1
1Division of Geriatric Medicine and Gerontology, Department of Medicine, The Johns Hopkins University, 5200, Eastern Avenue, Suite , 2200 Baltimore, MD, 21224, USA.
Current geriatrics reports
|June 10, 2024
概括
紧急诊所面临着一种狂妄症流行,特别是在老年人中. 本次审查确定了ED中有效的妄想预防和治疗计划的九个关键组成部分,旨在寻找务实和经济有效的解决方案.
科学领域:
- 老年医学 老年医学
- 紧急医疗 紧急医疗
- 神经科学是一个神经科学.
背景情况:
- 紧急部门 (ED) 经历了严重的拥挤和登机,特别影响那些容易患上妄想症的老年人.
- 在ED中,妄想与不良结果有关,包括并发症增加,住院时间延长,死亡率增加和医疗保健成本增加.
- 目前用于预防和治疗ED狂妄症的策略在务实,可持续和成本效益的应用方面是有限的.
研究的目的:
- 对最近关于精华症预防和治疗方案的文献进行叙事审查,特别是在急诊室设置中.
- 识别和描述EDs可以实施的成功妄想管理策略的基本组成部分.
- 为ED患者提供指导,帮助他们制定和建立自己的妄想管理计划.
主要方法:
- 2005年至2023年间发表的10项研究的叙述性综述,重点关注ED时的妄想干预.
- 在选定的研究中报告的各种干预组件的分析.
- 综合发现,以确定有效妄管理的共同要素.
主要成果:
- 在ED中确定了成功预防和治疗妄症策略的九个核心组成部分.
- 研究的干预措施包括优化血液动力学,氧化,疼痛管理,水分,营养,睡眠和感官刺激.
- 策略还包括避免使用某些药物 (镇静催眠药,抗精神病药,抗胆药),限制ED时间,员工教育,并将多学科协议纳入EHR.
结论:
- 在ED中有效的妄想管理需要采用包含已识别的关键组件的多方面的方法.
- 需要进一步进行高质量的研究,以确定妄想预防策略中最有效的单个组件.
- 为了更广泛的适用性,建议优先研究非部骨折人群.
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