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救护车服务中疑似脓毒症患者的评估:一项定性访谈研究。

Assessment of patients with suspected sepsis in ambulance services: a qualitative interview study.

机构信息

University of Borås, PreHospen, Centre for Prehospital Research, SE- 405 30, Borås, Sweden.

University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden.

出版信息

BMC Emerg Med. 2021 Apr 9;21(1):45. doi: 10.1186/s12873-021-00440-4.

Abstract

BACKGROUND

The initial care of patients with sepsis is commonly performed by ambulance clinicians (ACs). Early identification, care and treatment are vital for patients with sepsis to avoid adverse outcomes. However, knowledge about how patients with sepsis are assessed in ambulance services (AS) by AC is limited. Therefore, the aim of this study was to explore the meaning of ACs' lived experiences in assessing patients suspected of having sepsis.

METHODS

A descriptive design with a qualitative approach was used. Fourteen ACs from three Swedish ambulance organizations participated in dyadic and individual semistructured interviews. A thematic analysis based on descriptive phenomenology was performed.

RESULTS

AC experiences were grouped into four themes: (1) being influenced by previous experience; (2) searching for clues to the severity of the patient's condition; (3) feeling confident when signs and symptoms were obvious; and (4) needing health-care professionals for support and consultation.

CONCLUSIONS

This study indicates that several factors are important to assessments. ACs needed to engage in an ongoing search for information, discuss the cases with colleagues and reconsider the assessment throughout the entire ambulance mission. A reflective and open stance based on professional knowledge could contribute to recognizing patients with sepsis.

摘要

背景

脓毒症患者的初步治疗通常由救护车临床医生(AC)进行。早期识别、护理和治疗对脓毒症患者至关重要,可避免不良后果。然而,关于 AC 如何在救护车服务(AS)中评估疑似脓毒症患者的知识有限。因此,本研究旨在探讨 AC 在评估疑似脓毒症患者时的体验。

方法

采用描述性设计和定性方法。来自瑞典三个救护车组织的 14 名 AC 参与了二元和个人半结构化访谈。采用基于描述现象学的主题分析。

结果

AC 的经验分为四个主题:(1)受以往经验的影响;(2)寻找患者病情严重程度的线索;(3)当症状和体征明显时感到有信心;(4)需要医疗保健专业人员的支持和咨询。

结论

本研究表明,评估时需要考虑几个因素。AC 需要不断寻找信息,与同事讨论病例,并在整个救护车任务过程中重新评估评估。基于专业知识的反思和开放立场有助于识别脓毒症患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb36/8033740/796ad9bf4ffc/12873_2021_440_Fig1_HTML.jpg

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