在医院前的儿科止痛治疗中存在障碍和促进因素
Hoi See Tsao1, Tanya Sutcliffe2, Charles Wang3
1Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas.
Prehospital emergency care
|November 19, 2024
概括
紧急医疗服务 (EMS) 的临床医生发现鼻内芬太尼改善了儿科疼痛管理. 然而,护理人员的担忧和缺乏经验等障碍仍然存在,这凸显了需要加强EMS儿科培训的必要性.
科学领域:
- 紧急医疗 紧急医疗
- 儿科护理 儿科护理
- 疼痛管理 疼痛管理
背景情况:
- 儿童占紧急医疗服务 (EMS) 运输的5-10%,并面临治疗不足的疼痛风险.
- 之前的研究发现了EMS中儿科止痛的促进因素 (例如,教育,领导力支持) 和障碍因素 (例如,静脉输液疼痛,护理人员担忧,安全担忧).
- 这项研究评估了影响医院前儿科疼痛管理的因素,在将鼻内 (IN) 芬太尼纳纳入EMS协议后.
研究的目的:
- 评估在医院前环境中为患有创伤性疼痛的儿童提供镇痛的促进因素和障碍.
- 了解EMS临床医生在引入鼻内芬太尼后对儿科疼痛管理的观点.
- 在EMS中确定儿科小儿痛疗法的改进领域.
主要方法:
- 专注小组与EMS临床医生一起进行,以收集有关儿科止痛的见解.
- 讨论内容包括儿童运输,止痛药的决策,可用的资源,患者/家庭反应和改善策略.
- 使用结构化,开放式问题的演方法来探索主题,直到和.
主要成果:
- 启用因素包括更长的运输时间,患者稳定目标,严重疼痛指标和临床医生的舒适性/IN芬太尼的可用性.
- 障碍包括对患者稳定性的担忧,掩盖症状,缺乏儿科经验,IV接入困难以及护理人员的犹/缺乏知识.
- 关键主题包括缺乏儿科经验,医疗控制的价值,以及现实的培训的重要性.
结论:
- 较长的运输时间和临床医生的舒适性与IN疼痛药物出现了作为儿童镇痛的新推动者.
- 持续存在的障碍包括由于救护车暂停不良以及护理人员对医院前药物的知识有限而导致的IV接入问题.
- 增强EMS儿科培训和经验对于改善儿科疼痛管理和减少小疼痛至关重要.
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