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术前麻醉病例量较高可降低死亡率:对大批伤员救治的启示。

Higher pre-hospital anaesthesia case volumes result in lower mortality rates: implications for mass casualty care.

机构信息

Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria.

Department of Emergency Medicine, Alaska Native Medical Center, Anchorage, AK, USA; Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA, USA.

出版信息

Br J Anaesth. 2022 Feb;128(2):e89-e92. doi: 10.1016/j.bja.2021.10.022. Epub 2021 Nov 15.

Abstract

Senior physicians with a higher pre-hospital anaesthesia case volume have higher first-pass tracheal intubation success rates, shorter on-site times, and lower patient mortality rates than physicians with lower case volumes. A senior physician's skill set includes the basics of management of airway and breathing (ventilating and oxygenating the patient), circulation, disability (anaesthesia), and environment (especially maintaining core temperature). Technical rescue skills may be required to care for patients requiring pre-hospital airway management especially in hazardous environments, such as road traffic accidents, chemical incidents, terror attacks or warfare, and natural disasters. Additional important tactical skills in mass casualty situations include patient triage, prioritising, allocating resources, and making transport decisions.

摘要

高术前麻醉病例量的资深医师比低病例量的医师具有更高的首次气管插管成功率、更短的现场时间和更低的患者死亡率。资深医师的技能包括管理气道和呼吸(给患者通气和供氧)、循环、残疾(麻醉)和环境(特别是维持核心体温)的基本知识。在需要院前气道管理的患者的救治中,可能需要技术救援技能,特别是在危险环境中,如道路交通意外、化学事故、恐怖袭击或战争以及自然灾害。在大规模伤亡情况下,其他重要的战术技能包括患者分类、优先排序、分配资源和做出转运决策。

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