Guanyuan Central Hospital, Guanyuan, Sichuan, China.
The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
BMC Emerg Med. 2023 Apr 25;23(1):44. doi: 10.1186/s12873-023-00815-9.
Medical device-related pressure injuries(MDRPI) are prevalent and attracting more attention. During ambulance transfer, the shear force caused by braking and acceleration; extensive medical equipment crowed in a narrow space add external risk factors for MDRPIs. However, there is insufficient research on the relationship between MDRPIs and ambulance transfers. This study aims to clarify the prevalence and characteristics of MDRPI during ambulance transfer.
A descriptive observational study was conducted with convenience sampling. Before starting the study, six PI specialist nurses certified by the Chinese Nursing Association trained emergency department nurses for three MDRPI and Braden Scale sessions, one hour for each session. Data and images of PIs and MDRPIs are uploaded via the OA system by emergency department nurses and reviewed by these six specialist nurses. The information collection begins on 1 July 2022 and ends on 1 August 2022. Demographic and clinical characteristics and a list of medical devices were collected by emergency nurses using a screening form developed by researchers.
One hundred one referrals were eventually included. The mean age of participants was (58.3 ± 11.69) years, predominantly male (67.32%, n = 68), with a mean BMI of 22.48 ± 2.2. The mean referral time among participants was 2.26 ± 0.26 h, the mean BRADEN score was 15.32 ± 2.06, 53.46% (n = 54) of participants were conscious, 73.26% (n = 74) were in the supine position, 23.76% (n = 24) were in the semi-recumbent position, and only 3 (2.9%) were in the lateral position. Eight participants presented with MDRPIs, and all MDRPIs are stage 1. Patients with spinal injuries are most prone to MDRPIs (n = 6). The jaw is the area most prone to MDRPIs, caused by the cervical collar (40%, n = 4), followed by the heel (30%, n = 3) and nose bridge (20%, n = 2) caused by the respiratory devices and spinal board.
MDRPIs are more prevalent during long ambulance referrals than in some inpatient settings. The characteristics and related high-risk devices are also different. The prevention of MDRPIs during ambulance referrals deserves more research.
医疗器械相关性压力性损伤(MDRPI)较为普遍,受到越来越多的关注。在救护车转运过程中,刹车和加速产生的剪切力;狭窄空间中大量的医疗设备会增加 MDRPIs 的外部风险因素。然而,目前对于 MDRPIs 与救护车转运之间的关系研究还不够充分。本研究旨在阐明救护车转运过程中 MDRPI 的发生情况和特点。
采用描述性观察性研究,采用便利抽样法。在研究开始前,由中国护理协会认证的 6 名压疮专科护士对急诊护士进行了 3 次 MDRPI 和Braden 量表培训,每次 1 小时。由急诊护士通过 OA 系统上传压疮和 MDRPI 的相关数据和图像,由这 6 名专科护士进行审核。信息收集工作于 2022 年 7 月 1 日开始,8 月 1 日结束。由急诊护士使用研究人员制定的筛查表收集人口统计学和临床特征以及医疗器械清单。
最终纳入 101 例转诊患者。参与者的平均年龄为(58.3±11.69)岁,主要为男性(67.32%,n=68),平均 BMI 为 22.48±2.2。参与者的平均转诊时间为 2.26±0.26 h,平均 Braden 评分为 15.32±2.06,53.46%(n=54)的参与者意识清醒,73.26%(n=74)处于仰卧位,23.76%(n=24)处于半卧位,仅有 3 名(2.9%)处于侧卧位。8 名患者出现 MDRPI,均为 1 期。脊髓损伤患者最易发生 MDRPI(n=6)。颏部是最易发生 MDRPI 的部位,由颈托引起(40%,n=4),其次是由呼吸设备和脊柱板引起的足跟(30%,n=3)和鼻梁(20%,n=2)。
与一些住院环境相比,长途救护车转诊过程中 MDRPI 更为普遍。其特征和相关高危设备也有所不同。救护车转诊过程中 MDRPI 的预防值得进一步研究。