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美国医院前布普伦诺芬管理计划的实施障碍:范围审查
Mirinda Ann Gormley1,2,3, Phillip Moschella1,2,3, Tina Pham2
1Prisma Health Department of Emergency Medicine, Greenville, South Carolina.
Prehospital emergency care
|March 4, 2025
概括
医院前布诺芬管理计划 (PBAP) 在美国正在扩大,但实施障碍和位置的记录很少. 这次审查绘制了PBAP操作图,并确定了紧急医疗服务 (EMS) 系统的挑战.
科学领域:
- 公共卫生 公共卫生
- 紧急医疗服务 紧急医疗服务
- 药理学 药理学是指药理学的学科.
背景情况:
- 医院前布普伦诺芬管理计划 (PBAP) 越来越多地被美国紧急医疗服务 (EMS) 系统采用.
- 关于这些重要计划的地理分布和实施挑战的数据有限.
- 这种缺乏信息阻碍了EMS机构成功地采用和扩展PBAP.
研究的目的:
- 在全国范围内确定医院前布普伦诺芬管理计划 (PBAP) 的当前运营地点.
- 总结通常遇到的阻碍PBAP实施的障碍.
- 为寻求采用或扩展这些重症监护模型的EMS系统提供见解.
主要方法:
- 进行了全面的范围审查,联系了EMS的州办公室,并利用了EMS医生全国协会的会员资格.
- 搜索了四个数据库,寻找在学术手稿,流行媒体和会议记录中提到的PBAP,直到2024年8月25日.
- 数据提取的重点是PBAP的位置,人员,协议,并确定了实施障碍,遵守PRISMA-ScR指南.
主要成果:
- 19个州和华盛顿特区报告了活跃的PBAP;28个州报告没有PBAP,3个州尚未实施.
- 来自包括17个来源的数据显示,在8个州有13个独特的PBAP,主要由9-1-1护理人员或社区护理人员运营.
- 关键障碍包括患者相关问题 (例如,获得治疗,随访) 和运营挑战 (例如,COVID-19限制,服务隔离,协议不一致,布普伦诺芬采购).
结论:
- 虽然PBAP存在于美国19个州和华盛顿特区,但报告其实施和障碍的文献仍然很少.
- 有关患者和运营方面的重大挑战阻碍了PBAP的广泛成功.
- 开发用于评估PBAP实施的标准化指标对于全国范围内通知和支持EMS机构至关重要.
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