明尼苏达州重症监护工作组2:在COVID-19大流行期间的危机状况,2021年7月至2022年3月
Sarah M Kesler1, Christina Bastin De Jong2, Christine Chell3
1University of Minnesota, Minneapolis, MN.
Chest
|November 29, 2024
概括
一个全州工作组在COVID-19激增期间确定了重症监护危机状况,但对护理过程的影响有限. 为未来的研究和政策提供了建议.
科学领域:
- 医疗保健操作 医疗保健操作
- 公共卫生政策 公共卫生政策
- 关键护理医学 关键护理医学
背景情况:
- 明尼苏达州关键护理工作组 (CCWG) 和伦理工作组 (EWG) 负责在COVID-19大流行期间规划关键护理操作,特别是2021年秋季的激增.
- 这些小组由明尼苏达州九个最大的卫生系统的跨专业领导人组成.
研究的目的:
- 确定全州范围的工作组是否可以协同分析实时证据以确定危机条件.
- 评估该小组在公共卫生危机期间参与国家领导人实施护理流程的能力.
主要方法:
- 在2021年秋季激增期间,CCWG和EWG几乎召开了会议,以分析证据并计划潜在的危机护理.
- 证据来源包括群体共识,联邦远程跟踪数据,患者安置数据,以及对医院和医疗保健专业人员的调查.
- 该小组制定了缓解策略,并与国家领导层进行了接触.
主要成果:
- 证据表明危机状况:COVID-19患者数量上升,第三级护理转移困难,急诊室拥挤,ICU分配团队激活和低患者安置率.
- 医院调查显示,人员调整,远程医疗的扩张,以及推迟的非紧急程序.
- 医疗保健专业调查报告了患者的不良结果,配给,隐性分类和道德困境. 领导层的参与导致公众发送信息,但ICU分配或转移管理没有变化.
结论:
- 在COVID-19爆发期间,CCWG收集了医疗保健专业人员危机状况和道德困境的证据.
- 工作组对实际护理过程的影响有限.
- 这篇文章分析了该小组的努力,并为研究人员和政策制定者提出了建议.
相关概念视频
Acute Respiratory Failure-II
174
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
174
Acute Respiratory Failure-III
159
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
159
Acute Respiratory Failure-IV
126
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
126
Acute Respiratory Failure-I
173
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
173
Pneumonia III: Complications and Assessment
168
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
168
Acute Respiratory Failure-V
123
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
123


