Giacalone Sylvia, Pasquier Mathieu, Genoud Mathieu, Marti Christophe, Grosgurin Olivier, Beysard Nicolas
Service des urgences, CHUV, 1011 Lausanne.
Service des urgences HUG, 1211 Genève 14.
Rev Med Suisse. 2017 Jan 11;13(544-545):70-73.
Several articles have been published during 2016 suggesting amendments in certain established practices of emergency medicine. Amongst such practices now in question are : 1) the use in mechanical cardiopulmonary resuscitation of amiodarone and lidocaine which appear not to improve survival or neurological outcome ; 2) apneic oxygenation being associated with a significant increase in first pass success intubation ; 3) an updating of the definition of sepsis and septic shock which facilitate earlier identification of susceptible patients ; 4) the use of the high sensitivity troponin 0-hour / 1-hour algorithm which differentiates earlier patients with or without acute myocardial infarction ; 5) that intramuscular non-steroidal anti-inflammatory drugs offer effective sustained analgesia for renal colic, and finally 6) that irrigation of an abscess cavity after incision and drainage is not beneficial.
2016年期间发表了几篇文章,建议对某些既定的急诊医学实践进行修正。目前受到质疑的此类实践包括:1)在机械心肺复苏中使用胺碘酮和利多卡因,这似乎并不能提高生存率或改善神经功能结局;2)无氧通气与首次插管成功显著增加相关;3)更新脓毒症和脓毒性休克的定义,这有助于更早识别易感患者;4)使用高敏肌钙蛋白0小时/1小时算法,以更早区分有无急性心肌梗死的患者;5)肌肉注射非甾体抗炎药可为肾绞痛提供有效的持续镇痛,最后6)切开引流后对脓肿腔进行冲洗并无益处。