Fuchs Karin M, Miller Russell S, Berkowitz Richard L
Division of Maternal Fetal Medicine, Columbia Presbyterian Medical Center, New York, NY 10032, USA.
Semin Perinatol. 2009 Apr;33(2):104-8. doi: 10.1053/j.semperi.2008.12.002.
Delay in diagnosis, failure to employ sufficient medical and surgical treatments, and poor teamwork all may contribute to suboptimal outcomes in cases of postpartum hemorrhage. A significant portion of hemorrhage-related maternal morbidity may be prevented through early diagnosis and rapid intervention. There is a small but growing body of literature describing the role of patient safety initiatives and simulation training in optimizing outcomes following postpartum hemorrhage. Rapid response teams may be used to facilitate coordination between various personnel involved in the management of postpartum hemorrhage. Hemorrhage drills and simulation-based training may help providers achieve timely and coordinated responses in the treatment of postpartum hemorrhage. Protocol may help to standardize management in cases of postpartum hemorrhage, thereby minimizing unnecessary errors or delays in care. Additional research is warranted to further determine the impact of patient safety initiatives and simulation training on outcomes in the setting of obstetric hemorrhage.
诊断延误、未能采用足够的药物和手术治疗以及团队协作不佳,都可能导致产后出血病例的治疗效果不理想。通过早期诊断和快速干预,可预防很大一部分与出血相关的孕产妇发病情况。有一小部分但数量在不断增加的文献描述了患者安全举措和模拟培训在优化产后出血治疗效果方面的作用。快速反应团队可用于促进参与产后出血管理的各类人员之间的协调。出血演练和基于模拟的培训可能有助于医护人员在产后出血治疗中实现及时和协调的应对。方案可能有助于规范产后出血病例的管理,从而将护理中不必要的错误或延误降至最低。有必要进行更多研究,以进一步确定患者安全举措和模拟培训对产科出血情况下治疗效果的影响。