基于ED观察单位的延迟舒适护理途径,用于支持生命的ED患者
Jiayin Sun1, Melissa D'Souza2, Michael Losak1
1Department of Emergency Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
The American journal of emergency medicine
|January 23, 2025
概括
在急诊部观察单元 (EDOU) 中,延迟舒适护理的新途径允许在等待家庭到来时接受生命支持的危急病人接受护理. 这种方法成功地促进了富有同情心的终身护理,没有不良事件或ICU转移.
科学领域:
- 紧急医疗 紧急医疗
- 关键护理医学 关键护理医学
- 抚慰性护理是一种缓解性护理.
背景情况:
- 生命支持的重症患者可能需要由代孕决策者做出的舒适护理决定.
- 延迟启动家庭告别的安慰护理,可能会导致急诊室 (ED) 停留时间延长或重症监护室 (ICU) 的入院.
研究的目的:
- 评估基于紧急部门观察单位 (EDOU) 的新型延迟舒适护理途径的可行性.
- 评估该途径在为需要生命支持的患者提供富有同情心的终身护理方面的有效性.
主要方法:
- 2013年8月至2023年2月期间延迟舒适护理途径患者电子健康记录的回顾性分析.
- 纳入标准:接受侵入性机械通风和/或血管压缩器的患者,没有生命支持定位的代孕协议,并在EDOU入院18小时内开始舒适护理.
- 排除标准:器官捐献潜力,缺乏EDOU的私人房间或护理资源. 主要结局:家庭到来后接受舒适护理的患者比例.
主要成果:
- 23名患者使用该途径;平均年龄76岁,女性48%. 常见的诊断包括内出血 (57%),心脏骤停 (26%) 和呼吸衰竭 (17%).
- 100%的患者在舒适护理开始之前预计所有家庭成员都会到达.
- 所有患者都在EDOU入院后18小时内接受了舒适护理;没有任何不良事件,舒适护理前死亡或ICU转移发生.
结论:
- 基于EDOU的延迟舒适护理途径是提供富有同情心的终身护理的可行和安全方法.
- 这种途径对于私人ED床位和ICU资源有限的医院尤其有价值.
- 它为生命支持等待家庭告别的患者提供了有尊严的过渡.
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