在医院前产科紧急情况期间,与患者安全事件相关的频率和因素
Rebecca E Cash1,2, Maeve F Swanton1, Melissa A Meeker1
1Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts.
Prehospital emergency care
|June 4, 2025
概括
患者安全事件 (PSE) 在非医院产科紧急情况中很常见. 识别高风险患者群体可以指导干预措施,以改善紧急医疗服务 (EMS) 治疗分娩和产后出血 (PPH) 期间的护理.
科学领域:
- 紧急医疗 紧急医疗
- 产科 产科 产科 产科 产科
- 患者安全 患者安全
背景情况:
- 患者安全事件 (PSE) 在高急性和儿科患者的医院前护理中得到了充分记录.
- 然而,在医院前的产科紧急情况中,关于PSE的数据有限.
研究的目的:
- 调查外科医院分娩和产后出血 (PPH) 期间与PSE相关的频率和因素.
- 为了检查美国紧急医疗服务 (EMS) 临床医生治疗的PSE.
主要方法:
- 对12至50岁的非医院分娩或PPH患者的高级生命支持EMS 9-1-1激活的横截面分析 (2018-2019年国家EMS信息系统).
- PSE被定义为与EMS干预相关的不良事件,非最佳行动或错误.
- 修改Poisson混合效应回归模型用于计算流行率和边际调整流行率.
主要成果:
- 观察到高比例的PSE:27%的医院外分娩 (n=7283) 和69%的PPH (n=1273).
- 与PSE在分娩中的较低流行率相关的因素包括多倍数,早产,较短的现场时间和更高的社区多样性.
- 与更高的PSE发病率相关的因素包括产科医院的存在和分娩并发症. 对于PPH,并发症,倍数,更长的现场时间,社区脆弱性和医院存在增加了PSE风险.
结论:
- 显著的PSE发生率发生在医院前产科紧急情况期间,包括医院外分娩和PPH.
- 特定的患者子组面临更高的风险,需要针对性的教育和系统级干预措施.
- 了解这些风险因素对于制定减轻PSE在这个脆弱人群中的战略至关重要.
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