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胰岛素的安全性介绍在军事路线关键护理运输过程中
Richard Strilka1, Shelia C Savell2, Krystal K Valdez-Delgado2
1Center for Sustainment of Trauma and Readiness Skills, University of Cincinnati, Cincinnati, OH 45219, United States.
Military medicine
|October 8, 2025
概括
关键护理航空运输 (CCAT) 团队很少使用胰岛素输注,但这些与高低血糖率有关. 可靠的葡萄糖监测对于飞行中的胰岛素安全至关重要.
科学领域:
- 航空医疗疏散服务
- 临界护理医学 临界护理医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 航空医疗疏散具有独特的压力因素,增加药物不良事件的风险.
- 在路线护理 (ERC) 中的药物错误,特别是与胰岛素等高风险药物相关的药物错误,记录不充分.
- 了解飞行中的胰岛素管理对于重症监护航空运输 (CCAT) 团队至关重要.
研究的目的:
- 描述CCAT在飞行中的胰岛素注射和葡萄糖监测实践.
- 确定与空中医疗运输期间使用胰岛素相关的干预措施.
- 为CCAT培训和临床实践指南提供信息.
主要方法:
- 对接受胰岛素治疗的患者的美国空军CCAT任务记录 (2012-2022) 的回顾性审查.
- 研究护士使用表格3899L将数据抽象到Excel数据库中.
- 使用SAS进行描述性和单变量分析;按给药途径测定低血糖率的费舍尔精确测试.
主要成果:
- 在2,998名患者记录中,有2%记录了胰岛素的使用 (n=59).
- 胰岛素路线包括皮下 (51),静脉注射 (15),输液 (13).
- 低血糖 (BG <70 mg/dL) 在6.8%的患者中发生;46%的输液在2小时内缺乏BG检查.
结论:
- 虽然很少见,但CCAT团队输注胰岛素的低血糖率很高 (23%).
- 静脉注射胰岛素通常缺乏足够的葡萄糖监测.
- 在临床关键护理 (ERCC) 中,建议用皮下胰岛素作为第一线治疗高血糖症,除非确保可靠的监测.
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