Baugh Christopher W, Sodickson Aaron D, Kivlehan Sean M, Chen Paul C, Perencevich Molly L, Jesudian Arun B
Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Clin Exp Gastroenterol. 2023 Apr 26;16:55-58. doi: 10.2147/CEG.S404247. eCollection 2023.
Patients with gastrointestinal (GI) bleeding present to the emergency department (ED) with a wide spectrum of illness severity. Among the most critically ill patients, comorbidities and other risk factors, such as liver disease and anticoagulation, can complicate their management. These patients are resource-intensive to stabilize and resuscitate, often requiring the continuous attention of multiple ED staff members along with rapid mobilization of specialty care. At a tertiary care hospital with the ability to provide definitive care for the most critically ill patients with GI bleeding, we introduced a multi-disciplinary team activation pathway to bring together specialists to immediately respond to the ED. We designed a Code GI Bleed pathway to expedite hemodynamic stabilization, diagnostics, source control, and timely disposition out of the ED to the intensive care unit or relevant procedural area of the hospital.
胃肠道(GI)出血患者前往急诊科(ED)时病情严重程度差异很大。在病情最危急的患者中,合并症和其他风险因素,如肝病和抗凝治疗,会使他们的治疗变得复杂。这些患者需要大量资源来稳定病情和进行复苏,通常需要多名急诊科工作人员持续关注,并迅速调动专科护理。在一家能够为病情最危急的胃肠道出血患者提供确定性治疗的三级医院,我们引入了多学科团队启动途径,召集专家立即对急诊科做出反应。我们设计了“胃肠道出血急救方案”,以加快血流动力学稳定、诊断、源头控制,并及时将患者从急诊科转出至重症监护病房或医院的相关诊疗区域。