上腺素给药后观察期的评估实践模式
Benjamin Walters1, Hanna B Short1, Nigel Ravida1
1Emergency Medicine Department, Pennsylvania State College of Medicine, Hershey, Pennsylvania.
The Journal of emergency medicine
|August 26, 2025
概括
在服用上腺素后,急诊室的观察时间平均为235分钟,符合指导方针. 经历两相反应的患者的观察时间更长,突出显示严重病例需要延长监测.
科学领域:
- 紧急医疗
- 过敏和免疫学
- 临床实践指南
背景情况:
- 过敏反应是一种严重的医疗紧急情况,需要立即治疗上腺素并进行随后的观察.
- 美国国家过敏和传染病研究所 (NIAID) 建议在过敏症缓解后至少观察4至6小时,以检测两相反应.
研究的目的:
- 评估当前的急诊室 (ED) 关于过敏患者在服用上腺素后的观察时间的做法.
- 分析辅助医疗管理,常见的过敏原以及过敏症患者的双相反应发生率.
主要方法:
- 对2017年1月至2022年9月的数据进行了回顾性图表审查.
- 纳入的患者是成年人 (≥18岁),接受过敏反应的上腺素,并有记录的观察期.
- 最初确定了1751名患者,其中488人符合纳入标准;1263人因未接受上腺素而被排除在外.
主要成果:
- 在上腺素后的ED观察时间中位数为235分钟.
- 在4. 29%的患者 (21人) 中发生了双相反应.
- 与没有双相反应的患者相比,双相反应的患者的平均观察时间 (451. 38分钟) 显著更长 (262. 13分钟,p < 0. 05).
结论:
- 在服用上腺素后观察到的ED观察时间与NIAID的4-6小时的指导方针一致.
- 延长观察与经历两相反应的患者有关,这突显了其临床重要性.
相关概念视频
Allergic Reactions
28.6K
Overview
28.6K
Adrenergic Agonists: Therapeutic Uses
947
Adrenergic agonists have diverse therapeutic uses across various medical conditions and emergencies.
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
Emergency and Intensive Care Unit (ICU) applications: Pressor agents increase blood pressure, heart rate, and contractility in shock and organ failure situations. Dopamine can induce vasodilation and stimulate adrenoceptors. Endogenous catecholamines are effective in treating cardiogenic shock. α2-agonists like clonidine can reverse anesthesia-induced hypertension.
Allergies and...
947
Cardiopulmonary Resuscitation IV: Pharmacological Management
75
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
75
Cardiopulmonary Resuscitation III: AED Use
68
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
68
Adrenergic Agonists: Mixed-Action Agents
869
Mixed-action adrenergic agonists, like ephedrine and pseudoephedrine, directly and indirectly affect adrenergic receptors. These agents stimulate adrenoceptors and indirectly release stored neurotransmitters, amplifying the adrenergic response.
Ephedrine and pseudoephedrine lack a catecholamine group, making them less susceptible to degradation by metabolic enzymes. They have increased oral bioavailability and lipophilicity, resulting in a longer duration of action. Their response is reduced by...
Ephedrine and pseudoephedrine lack a catecholamine group, making them less susceptible to degradation by metabolic enzymes. They have increased oral bioavailability and lipophilicity, resulting in a longer duration of action. Their response is reduced by...
869
Cardiac Catheterization IV: Nursing Management
193
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
193


