儿科大规模输血协议剂量手册:改善均衡比率的指南
Tiffany L Taylor1, Joshua Dugal, Steven P Laffey
1Author Affiliations: Trauma Program Manager, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri (Ms Taylor); Senior Director of Trauma and Burn Services, Regional One Health Elvis Presley Trauma Center, Memphis, Tennessee (Mr Dugal); Division of Pediatric Emergency Medicine, St. Louis University School of Medicine, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri (Dr Laffey); Section of Emergency Medicine, Children's Hospital Colorado Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado (Dr Spencer); and Division of Critical Care Medicine, Department of Pediatrics Saint Louis University School of Medicine, SSM Health Cardinal Glennon Children's Hospital, St. Louis, Missouri (Dr Thompson).
一个新的儿科大规模输血协议剂量手册显著改善了创伤患者的红细胞与血的比例. 这种工具在关键事件期间增强了平衡的复苏.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 复苏医学 复苏医学 复苏医学
- 改善医疗保健的质量
背景情况:
- 儿科大规模输血协议 (MTP) 的激活不常见,在高风险场景中保持临床医生的能力具有挑战.
- 在儿童大规模输血事件期间确保均衡的复苏至关重要,但往往难以实现.
研究的目的:
- 评估新型儿科大规模输血协议剂量手册对包装红细胞 (PRBC) 与血比率的影响.
- 评估基于体重的剂量手册在指导儿科创伤患者平衡复苏的有效性.
主要方法:
- 在一级儿科创伤中心进行了一项为期5年的质量改善研究.
- 包括在24小时内接受≥40毫升/公斤血制品的18岁以下创伤患者.
- 干预措施:实施基于体重的剂量手册,以指导PRBC和血的使用.
主要成果:
- 平均PRBC与血的比率从实施前的3.38:1提高到实施后的1.37:1.
- 在29次大规模输血激活 (14次前,15次后) 中观察到这种改善.
结论:
- 儿科大规模输血协议剂量手册有效提高了对平衡血液产品管理的坚持.
- 这种干预表明了改善儿科大规模输血事件结果的成功策略.
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