创伤复苏中，使用药剂师对插管后镇静和镇痛药物使用时机的影响。

Effect of a pharmacist on timing of postintubation sedative and analgesic use in trauma resuscitations.

机构信息

Department of Surgery, College of Medicine, University of Arizona (UA), Tucson, AZ, USA.

出版信息

Am J Health Syst Pharm. 2013 Sep 1;70(17):1513-7. doi: 10.2146/ajhp120673.

DOI:10.2146/ajhp120673

PMID:23943183

Abstract

PURPOSE

Pharmacists' impact in reducing the time interval from intubation to sedative and analgesic use during trauma patient resuscitations is investigated.

METHODS

A retrospective cohort study was conducted at a level 1 trauma center to compare medication-use outcomes in consecutive cases in which trauma patients underwent rocuronium-assisted rapid-sequence intubation (RSI) and subsequent sedation and analgesia with or without a pharmacist's participation on the resuscitation team. The primary and secondary outcomes were, respectively, the time to sedative provision and the time to analgesic provision after intubation.

RESULTS

Relative to resuscitation cases not involving a pharmacist, the presence of the pharmacist during RSI was associated with decreased mean times to provision of postintubation sedation (9 minutes versus 28 minutes, p = 0.007) and analgesia (21 minutes versus 44 minutes, p = 0.057). The cumulative proportions of patients receiving appropriate sedation 5, 10, and 15 minutes after intubation were 11%, 26%, and 41% in the pharmacist-absent group and 33%, 53%, and 63% in the pharmacist-present group (p = 0.009, 0.008, and 0.045, respectively); for postintubation analgesic use, the corresponding figures were 9%, 14%, and 23% in the pharmacist-absent group and 17%, 30%, and 43% in the pharmacist-present group (p = 0.236, 0.066, and 0.039, respectively).

CONCLUSION

The presence of a pharmacist during RSI procedures was associated with decreased times to postintubation sedative and analgesic use, indicating that pharmacist participation in trauma-resuscitation responses can facilitate appropriate drug therapy.

摘要

目的

研究药师在减少创伤患者复苏过程中从插管到镇静和镇痛药物使用的时间间隔方面的作用。

方法

在一个一级创伤中心进行了一项回顾性队列研究，比较了连续接受罗库溴铵辅助快速序列插管（RSI）和随后镇静和镇痛的创伤患者的药物使用结果，这些患者的复苏团队中是否有药剂师参与。主要和次要结局分别是插管后镇静剂的提供时间和镇痛剂的提供时间。

结果

与没有药剂师参与的复苏病例相比，RSI 期间有药剂师在场与插管后镇静提供的平均时间减少相关（9 分钟对 28 分钟，p = 0.007）和镇痛（21 分钟对 44 分钟，p = 0.057）。在没有药剂师的情况下，插管后 5、10 和 15 分钟内接受适当镇静的患者比例分别为 11%、26%和 41%，而在有药剂师的情况下，相应的比例分别为 33%、53%和 63%（p = 0.009，0.008 和 0.045）；对于插管后的镇痛使用，在没有药剂师的情况下，相应的比例分别为 9%、14%和 23%，而在有药剂师的情况下，相应的比例分别为 17%、30%和 43%（p = 0.236，0.066 和 0.039）。