在怀疑开口骨折的情况下进行医院前的抗生素管理:联合COT/OTA/ACEP/NAEMSP/NAEMT立场声明
Joey P Johnson1, Bryant W Oliphant2, Jimm Dodd3
1Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Prehospital emergency care
|October 2, 2024
概括
建议给开放骨折患者服用医院前的抗生素,特别是第一代头类抗生素,以防止感染. 这种关键的干预不应该延迟运输,对于大多数患者来说是安全的,包括那些患有青素过敏的人.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 传染性疾病 传染性疾病
背景情况:
- 开放性骨折带来了与骨折相关的感染 (FRI) 的重大风险.
- 预防性抗生素的早期使用对于最大限度地减少FRI和随后的发病率至关重要.
- 医院前的抗生素管理是紧急医疗服务 (EMS) 实践范围的新兴但有价值的扩展.
研究的目的:
- 建立基于共识的建议,为怀疑开口骨折的患者在医院前的抗生素预防.
- 为EMS提供者提供有关适当使用抗生素以预防骨折相关感染的指导.
主要方法:
- 由领先的医疗组织 (COT,OTA,ACEP,NAEMSP,NAEMT) 进行的共识审查和建议制定.
- 专注于使用第一代类素作为主要预防剂.
- 这些指导方针涉及与生命威胁管理和患者过敏相关的施用时间.
主要成果:
- 对于开放骨折患者,建议在医院前给药一代头素.
- 抗生素的使用应在生命威胁得到控制后进行,不应延迟运输.
- 类药物适用于反应敏捷和的患者,包括那些有记录的青素过敏症患者,并进行适当的监测.
结论:
- 开放骨折的医院前抗生素预防是一种安全,经济有效,技术上简单的干预措施.
- 通过EMS早期使用抗生素可以显著降低骨折相关感染的风险.
- 这些建议旨在标准化和改进开放骨折的初始管理,减少长期并发症.
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