全州紧急医疗服务 现场启动血液复苏的协议
Jane M Hayes1,2,3, Melissa Fornagiel4, Adam Kipust5
1Harvard Medical School, Boston, Massachusetts.
Prehospital emergency care
|January 29, 2026
概括
在美国大多数州,全州紧急医疗服务 (EMS) 的医院前输血协议缺乏. 现有协议的差异很大,强调需要基于证据的指导方针来改善患者护理.
科学领域:
- 紧急医疗 紧急医疗
- 输血医学 输血医学
- 公共卫生政策 公共卫生政策
背景情况:
- 紧急医疗服务 (EMS) 的医院前输血改善了创伤患者的治疗结果.
- 全州的协议显著影响到医院前血液制品的可用性和使用.
- 对于现有的美国全州EMS协议,对现场启动输血的理解有限.
研究的目的:
- 描述有关美国各地实地启动的医院前血液和血液制品输血的全州EMS协议.
- 识别有关指示,产品类型和患者特定考虑的协议的变化.
主要方法:
- 通过高级生命支持 (ALS) 临床医生进行地面运输的公开可用的全州EMS协议的横截面分析.
- 不包括重症监护或设施间运输的协议.
- 标准化数据收集工具,用于比较临床指示,血液制品类型以及对儿科和孕育潜力的女性患者的考虑.
主要成果:
- 31个州和华盛顿特区有公开可用的协议;13个州 (42%) 允许实地启动医院前输血.
- 协议显示输血指示和管理细节的变化.
- 所有协议允许在创伤中输血,9 (69%) 在医疗紧急情况下. 在3个 (23%) 协议中指定了低位数O全血. 在9个 (69%) 方案中允许进行儿科输血,但仅在4个 (31%) 方案中对女性进行了特别考虑.
结论:
- 大多数美国州范围内的EMS协议目前不包括现场启动的输血.
- 在允许医院前输血的协议中存在显著的变化.
- 这些发现表明有机会制定更强大的,基于证据的准则,用于医院前输血,以提高患者的护理.
相关概念视频
Initiation of Translation
39.0K
Initiating translation is complex because it involves multiple molecules. Initiator tRNA, ribosomal subunits, and eukaryotic initiation factors (eIFs) are all required to assemble on the initiation codon of mRNA. This process consists of several steps that are mediated by different eIFs.
First, the initiator tRNA must be selected from the pool of elongator tRNAs by eukaryotic initiation factor 2 (eIF2). The initiator tRNA (Met-tRNAi) has conserved sequence elements including modified bases at...
First, the initiator tRNA must be selected from the pool of elongator tRNAs by eukaryotic initiation factor 2 (eIF2). The initiator tRNA (Met-tRNAi) has conserved sequence elements including modified bases at...
39.0K
Initiation of Translation
8.1K
8.1K
Emerging Adulthood
681
Jeffrey Arnett's concept of emerging adulthood offers a framework to understand the unique developmental stage between adolescence and full-fledged adulthood, generally from ages 18 to 25. This period is marked by extensive exploration and shifts in identity, relationships, and career choices, a process known in psychology as role experimentation. Emerging adulthood reflects the evolving cultural expectations surrounding adulthood and the dynamic process of personal transformation during...
681
Cardiopulmonary Resuscitation I: Adult
713
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
713
Transcription Initiation
20.9K
Initiation is the first step of transcription in eukaryotes. Prokaryotic RNA Polymerase (RNAP) can bind to the template DNA and start transcribing. On the other hand, transcription in eukaryotes requires additional proteins, called transcription factors, to first bind to the promoter region in the DNA template. This binding helps recruit the specific RNAP that can assemble on the DNA and start transcription.
The promoters and enhancers and their accessory proteins allow tight regulation of...
The promoters and enhancers and their accessory proteins allow tight regulation of...
20.9K
Inhaled Medications
795
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
795


