初级医院医生使用肾上腺素治疗过敏反应的调查。
Survey of the use of epinephrine (adrenaline) for anaphylaxis by junior hospital doctors.
作者信息
Jose Ricardo, Clesham Gerald J
机构信息
Department of Medicine, Broomfield Hospital, Chelmsford, UK.
出版信息
Postgrad Med J. 2007 Sep;83(983):610-1. doi: 10.1136/pgmj.2007.059097.
BACKGROUND
Anaphylaxis is a life threatening reaction where prompt and appropriate management can save lives. Epinephrine (adrenaline) is the treatment of choice; however, the recommended dose and route of administration of epinephrine used in the management of anaphylaxis is different from that used in the management of cardiac arrest.
OBJECTIVE
To investigate how junior doctors would administer epinephrine in a case of anaphylactic shock in an adult patient.
METHODS
Junior medical staff in two district general hospitals were assessed with a short questionnaire.
RESULTS
95 junior hospital doctors were assessed. The majority (94%) would administer epinephrine as the life saving drug of choice, but only 16.8% would administer it as recommended by the UK Resuscitation Council Guidelines.
CONCLUSION
Junior doctors may be called to make immediate management decisions in patients with anaphylaxis; however, widespread confusion exists regarding the dose and route of administration of epinephrine. Strategies to improve education and access to appropriate drugs are needed. A labelled "anaphylaxis box" on every resuscitation trolley, containing the dose of epinephrine with clear labelling for intramuscular use, may be one solution.
背景
过敏反应是一种危及生命的反应，及时且恰当的处理能够挽救生命。肾上腺素是治疗的首选药物；然而，用于过敏反应处理的肾上腺素推荐剂量和给药途径与用于心脏骤停处理的不同。
目的
调查初级医生在成年患者过敏性休克病例中会如何使用肾上腺素。
方法
用一份简短问卷对两家地区综合医院的初级医务人员进行评估。
结果
对95名初级医院医生进行了评估。大多数（94%）会将肾上腺素作为首选的救命药物使用，但只有16.8%会按照英国复苏委员会指南的推荐给药。
结论
初级医生可能会被要求对过敏反应患者做出即时处理决定；然而，对于肾上腺素的剂量和给药途径存在广泛的困惑。需要采取策略来改善教育并确保能获取合适的药物。在每个复苏推车上放置一个标有“过敏反应箱”的盒子，里面装有明确标注用于肌肉注射的肾上腺素剂量，可能是一种解决办法。
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