手部咬伤的门诊治疗:一种安全和经济有效的选择
Ibrahim I Haq1, Bhagat Manku1, Andrew Mahon1
1Trauma and Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, GBR.
Cureus
|July 15, 2024
概括
手部咬伤的门诊治疗显著减少了住院时间和手术的时间. 这种安全,具有成本效益的方法可以降低患者的成本,而不会增加骨髓炎的发病率.
科学领域:
- 整形医生 整形医生 整形医生
- 紧急医疗 紧急医疗
- 传染性疾病 传染性疾病
背景情况:
- 手咬有局部和全身并发症的风险,传统上需要住院治疗静脉注射抗生素和潜在的手术.
- 病例的增加和床上压力迫使对传统的手咬管理协议进行审查.
- 为了提高效率和成本效益,实施了对咬伤的门诊治疗的转变.
研究的目的:
- 评估在门诊 (行诊) 基础上管理手咬的可行性和安全性.
- 为了比较手部咬伤的门诊治疗与住院治疗的财务影响.
- 评估更新的手咬指南对患者治疗结果和资源利用的影响.
主要方法:
- 2017年 (准则之前) 和2023年 (准则之后) 紧急部门对成年人咬手咨询的回顾性审查.
- 分析最初的入院文件,操作笔记和临床后续信件.
- 关键指标的比较,包括手术的时间,住院时间,重复手术,骨髓炎发病率和每例患者的成本.
主要成果:
- 在2023年,平均住院时间从2017年的2.36天减少到0.56天,而手术的平均时间略有减少.
- 2023年没有记录任何骨髓炎病例,而2017年只有两例.
- 从2017年到2023年,每例患者的成本下降了40%,这表明了显著的成本节约.
结论:
- 更新的部门指南使手部咬伤的安全和经济有效的门诊管理成为可能,减少住院患者和手术延迟.
- 新协议显著降低了成本,但没有影响患者的安全,也没有增加像骨髓炎这样的感染率.
- 密切的患者随访和及时的手术干预对于确保门诊手部咬伤管理的安全至关重要,这需要进一步的研究.
相关概念视频
Hand hygiene
3.2K
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
3.2K
Handwashing II: Pre-procedure and Initial Procedure Steps
910
The pre-procedure steps of handwashing include removing jewelry and rolling up sleeves. However, many organizations allow staff to wear wedding rings.
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail...
The hand washing procedure itself includes the following steps. First, cover cuts, if any, on hands with a waterproof dressing. Cuts and abrasions can become contaminated with bacteria hindering the ability to clean the area thoroughly. In addition, repeated hand washing can worsen an injury. The nails must be short and clean, without nail...
910
Fractures: Bone Repair
3.2K
Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
3.2K
Handwashing I: Introduction and Types of Equipment
4.1K
Handwashing is hand hygiene with plain or antimicrobial soap and water to physically remove dirt, organic material, and microorganisms. However, it may not kill all microorganisms. The handwashing procedure requires a hand wash basin, liquid soap, paper towels, a domestic waste bin, and disposable nail cleaner as optional equipment.
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated....
Hand wash basins in clinical areas should have faucets that can be turned on and off without using the hands; that is, they should be non-touch or lever-operated....
4.1K
Tonsillitis II: Management
107
This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
107
Flail Chest-II
161
Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Assessment:
1. Clinical Evaluation:
History:
161


