将肌内上腺素添加到护理人员的标准护理中,以减少儿科医院外心脏骤停的初始上腺素剂量的时间:一个模拟试验
Jay Loosley1, Maysaa Assaf2,3, Katie McKenzie4
1Department of Education and Training, Middlesex-London Paramedic Service, London, Ontario, Canada.
Prehospital emergency care
|August 18, 2025
概括
通过自身注射器输入肌肉内 (IM) 的上腺素显著加快了模拟儿科外医院心脏骤停 (POHCA) 的初始药物输送速度. 这种更快的注射方法在传统的IV/IO路线上提供了关键的优势,可能会改善重症儿童的治疗结果.
科学领域:
- 儿科急救医学 儿科急救医学
- 心血管研究研究心血管研究
- 护理人员实践 护理人员实践
背景情况:
- 儿科外住院心脏骤停 (POHCA) 的存活率很低,强调需要快速有效的干预措施.
- 上腺素的使用至关重要,但在紧急情况下实现静脉 (IV) 或骨内 (IO) 接入往往是困难和耗时的.
- 替代性上腺素注射途径需要在模拟的POHCA场景中评估速度和准确性.
研究的目的:
- 为了评估在模拟的儿科医院外心脏骤停 (POHCA) 事件中对第一个上腺素剂量和剂量准确性的时间.
- 为了比较通过IV/IO,肌内 (IM) 自动注射器和IM针/注射器给药的上腺素.
主要方法:
- 护理人员被随机分配,通过IV/IO,IM自注射器或IM针/注射器向模拟POHCA中的儿科模型注射上腺素.
- 主要结局:到初始上腺素剂量的时间.
- 二次结果:最终血管接入 (IV/IO) 的时间和正确的上腺素剂量 (在目标的20%内).
主要成果:
- 与IV/IO相比,通过自身注射器输入肌肉内 (IM) 的上腺素显著减少了1.5分钟的初始剂量的时间 (p < 0.001).
- 通过针头/注射器输入上腺素显示没有时间优势,并导致最终IV/IO剂量的更多剂量错误.
- 与IV/IO (p = 0.002) 相比,使用IM自注射器时,保证血管接入的时间延迟了1:07分钟.
结论:
- 通过自身注射器输送肌内上腺素是一种可行且显著更快的方法,用于模拟POHCA中的初始上腺素注射.
- 这种方法在儿科紧急护理中比传统的IV/IO路线提供了关键的时间优势.
- 这些发现支持在POHCA管理中对IM上腺素进行人体试验的进一步调查.
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