在学术急诊医学中,监督内管管道输入过程中的临床决策
Joseph Offenbacher1, Jung G Kim1, Kenway Louie2
1Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, NY, United States of America.
The American journal of emergency medicine
|November 6, 2025
概括
住院护理经验的一致性影响了急诊室输管术中的喉腔镜技术选择. 然而,类似的多年实践并没有影响这些关键程序期间的麻剂选择.
科学领域:
- 紧急医疗 紧急医疗
- 医学教育 医学教育
- 临床决策 - 临床决策
背景情况:
- 在急诊室 (ED) 进行内管注射是一个关键的程序,需要技术技能和认知推理.
- 有限的证据表明,住院护理人员的资历如何影响ED输管治疗期间的决策.
研究的目的:
- 检查在住院护理医师的研究生年经验与他们在ED输管治疗期间选择喉镜技术和麻剂之间的关系.
主要方法:
- 从一个多个地点,城市,学术ED培训计划 (2013-2023) 进行2969次内内输管的回顾性分析.
- 使用一个标准化的预测器,在二元体内的多年临床经验中进行相似性.
- 应用调整的混合效应后勤回归来评估与喉腔镜技术 (直接与视频) 和麻剂 (短效与长效) 选择的关联.
主要成果:
- 住院医生和主治医生的经验年数一致,与选择直接喉腔镜 (DL) 而不是视频喉腔镜 (VL) 的可能性更高 (aOR 3.05).
- 在一致的经验和选择麻剂之间没有发现显著的关联.
结论:
- 住院医生和主治医生之间共享多年的临床实践与喉镜技术的选择相关,可能反映了技术技能的影响.
- 决策的认知方面,如麻剂的选择,并没有受到二元体内的经验一致的显著影响.
- 临床医生的经验可能在时间敏感的ED手术过程中起到决定的作用.
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