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经验教训:美国埃博拉患者的重症监护管理

Lessons learned: critical care management of patients with Ebola in the United States.

作者信息

Johnson Daniel W, Sullivan James N, Piquette Craig A, Hewlett Angela L, Bailey Kristina L, Smith Philip W, Kalil Andre C, Lisco Steven J

机构信息

1Division of Critical Care, Department of Anesthesiology, University of Nebraska Medical Center, Omaha, NE. 2Division of Pulmonary, Critical Care, Sleep, and Allergy, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE. 3Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE.

出版信息

Crit Care Med. 2015 Jun;43(6):1157-64. doi: 10.1097/CCM.0000000000000935.

Abstract

OBJECTIVE

This report will describe the preparations for and the provision of care of two patients with Ebola virus disease in the biocontainment unit at the University of Nebraska Medical Center.

DATA SOURCES

Patient medical records.

STUDY SELECTION

Not applicable.

DATA EXTRACTION

Not applicable.

DATA SYNTHESIS

Not applicable.

CONCLUSIONS

Safe and effective care of patients with Ebola virus disease requires significant communication and planning. Adherence to a predetermined isolation protocol is essential, including proper donning and doffing of personal protective equipment. Location of the patient care area and the logistics of laboratory testing, diagnostic imaging, and the removal of waste must be considered. Patients with Ebola virus disease are often dehydrated and need adequate vascular access for fluid resuscitation, nutrition, and phlebotomy for laboratory sampling. Advanced planning for acute life-threatening events and code status must be considered. Intensivist scheduling should account for the significant amount of time required for the care of patients with Ebola virus disease. With appropriate precautions and resources, designated hospitals in the United States can safely provide care for patients with Ebola virus disease.

摘要

目的

本报告将描述内布拉斯加大学医学中心生物安全隔离病房对两名埃博拉病毒病患者的护理准备及护理情况。

数据来源

患者病历。

研究选择

不适用。

数据提取

不适用。

数据综合

不适用。

结论

对埃博拉病毒病患者进行安全有效的护理需要大量的沟通与规划。必须严格遵守预先制定的隔离方案,包括正确穿戴和脱卸个人防护装备。必须考虑患者护理区域的位置以及实验室检测、诊断成像和废物处理的后勤工作。埃博拉病毒病患者常出现脱水,需要有足够的血管通路用于液体复苏、营养支持以及采集血样进行实验室检测。必须对急性危及生命事件和代码状态进行预先规划。重症监护医生的排班应考虑到护理埃博拉病毒病患者所需的大量时间。通过采取适当的预防措施并配备相应资源,美国指定的医院能够安全地为埃博拉病毒病患者提供护理。

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