在急诊室实施急性腹痛诊断途径
Samari Blomerus1, Tracy-Lee Splinter2, Amy Gillis3
1University Hospital Limerick, Dooradoyle, Ireland.
BMJ open quality
|August 20, 2025
概括
对急性腹痛的新诊断途径的实施大大减少了急诊室的入院时间. 这项质量改善举措简化了需要使用对比度增强的腹腔皮层CT扫描的患者的护理.
科学领域:
- 紧急医疗
- 放射学
- 外科病理学
背景情况:
- 急性腹痛是急诊室常见的情况.
- 增强对比度的腹腔皮层CT (AP CT) 是标准的成像方法.
- 现有的APCT访问程序被认为是复杂且耗时的.
研究的目的:
- 为患有急性腹痛的ED患者开发和实施诊断途径.
- 改善急性腹部病理患者的ED停留时间和处理时间.
- 在未分化的急性腹痛病例中提高高级成像效率.
主要方法:
- 一个高质量的干预项目,涉及阶段性的多学科方法.
- 放射科,整体外科和急诊医疗团队之间的合作.
- 修订APCT成像方案以主要使用静脉对比剂.
- 在实施前和之后收集和分析数据.
主要成果:
- 在ED停留时间的统计显著改善 (p<0.01).
- 从ED到APCT扫描的时间缩短的趋势不显著 (p=0.06).
- 在APCT上显著的急性病理的高诊断率为79.6%.
结论:
- 急性腹痛诊断途径有效地改善了ED的吞吐时间.
- 该途径显示相关患者队列的入院率有所降低.
- APCT扫描证实该途径适用于需要紧急成像的不分化急性腹痛.
相关概念视频
Acute Pancreatitis II: Clinical Manifestations and Management
176
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
176
Endoscopic Procedures V: ERCP
898
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
898
Acute Pyelonephritis II: Diagnostic Studies and Management
40
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
40
Appendicitis-II: Diagnostic Studies and Management
145
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
145
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
200
Peptic ulcer disease (PUD) presents with diverse symptoms depending on the location and severity of the ulcer. Clinical manifestations of peptic ulcer include dull pain and a burning sensation in the mid-epigastric region.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
200
Appendicitis-I: Introduction
620
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
620


