全血计划:在农村创伤中心实施
Lanny C Orr1, Alexa L Peterson, Tessa C Savell
1Author Affiliations: Trauma Services, (Mr Orr, Mrs Peterson, Mrs Savell, Mrs McCotter, and Mr Palm); Lab-Blood Bank, (Mrs Arnold); Trauma & Critical Care Surgery, (Dr Riha); and Collaborative Science & Innovation, Billings Clinic, Billings, Montana (Dr Thompson).
概括
在农村创伤环境中,全血输血显著降低了与组分疗法相比的死亡率. 该计划为严重受伤的患者提供了至关重要的护理,改善了结果并减少了浪费.
科学领域:
- 紧急医疗 紧急医疗
- 输血医学 输血医学
- 创伤外科 手术 创伤外科
背景情况:
- 血液成分的平衡输血对于创伤中的静血复苏至关重要.
- 之前关于全血输血的研究主要集中在城市创伤中心,在农村环境中留下了一个空白.
研究的目的:
- 为了比较成分疗法与全血疗法在农村创伤中心环境中的浪费率和死亡率方面的疗效.
主要方法:
- 在二级创伤中心进行了一项非随机,回顾性,观察性研究,持续了三年 (2020-2022年).
- 来自创伤登记册的数据提供了全血需求和供应可持续性的信息.
- 制定了全血使用的协议,每月监测利用率和实验室合规性.
主要成果:
- 在接受全血 (8%) 的患者中,死亡率明显低于接受组分治疗 (29%) 的患者 (p = .030).
- 全血的浪费率从2021年的43.4%下降到2022年的38.7%.
- 护士们发现全血更容易管理和记录,消除了对比例遵守的需要.
结论:
- 基于证据的全血输血计划可以为大型农村地区的重伤创伤患者提供必要的护理.
- 这种方法表明,在农村环境中改善了患者的治疗结果和有效的资源管理.
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