Tran Quincy K, O'Connell Francis, Hakopian Andrew, Abrahim Marwa Sh, Beisenova Kamilla, Pourmand Ali
Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore 21201, USA.
Program in Trauma, the R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore 21201, USA.
World J Emerg Med. 2023;14(1):3-9. doi: 10.5847/wjem.j.1920-8642.2023.009.
When critically ill patients require specialized treatment that exceeds the capability of the index hospitals, patients are frequently transferred to a tertiary or quaternary hospital for a higher level of care. Therefore, appropriate and efficient care for patients during the process of transport between two hospitals (interfacility transfer) is an essential part of patient care. While medical adverse events may occur during the interfacility transfer process, there have not been evidence-based guidelines regarding the equipment or the practice for patient care during transport.
We conducted searches from the PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and Scopus databases up to June 2022. Two reviewers independently screened the titles and abstracts for eligibility. Studies that were not in the English language and did not involve critically ill patients were excluded.
The search identified 75 articles, and we included 48 studies for our narrative review. Most studies were observational studies.
The review provided the current evidence-based management of diverse disease states during the interfacility transfer process, such as proning positioning for respiratory failure, extracorporeal membrane oxygenation (ECMO), obstetric emergencies, and hypertensive emergencies (aortic dissection and spontaneous intracranial hemorrhage).
当危重症患者需要超出基层医院能力范围的专科治疗时,患者常被转至三级或四级医院接受更高水平的护理。因此,在两家医院之间的转运过程(机构间转运)中为患者提供恰当且高效的护理是患者护理的重要组成部分。虽然在机构间转运过程中可能会发生医疗不良事件,但目前尚无关于转运期间患者护理设备或操作的循证指南。
我们检索了截至2022年6月的PubMed、护理及相关健康累积索引数据库(CINAHL)和Scopus数据库。两名综述员独立筛选标题和摘要以确定其是否符合纳入标准。排除非英文撰写且不涉及危重症患者的研究。
检索共识别出75篇文章,我们纳入了48项研究进行叙述性综述。大多数研究为观察性研究。
该综述提供了机构间转运过程中对多种疾病状态的当前循证管理方法,如呼吸衰竭的俯卧位通气、体外膜肺氧合(ECMO)、产科急症和高血压急症(主动脉夹层和自发性颅内出血)。