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儿科惊厥性癫痫持续状态的管理:从急诊护士的角度来看:一项横断面、多中心研究。

Management of Pediatric Convulsive Status Epilepticus From the Perspective of Emergency Nurses: A Cross-sectional, Multicenter Study.

出版信息

J Emerg Nurs. 2024 May;50(3):364-372. doi: 10.1016/j.jen.2024.01.006. Epub 2024 Mar 13.

Abstract

INTRODUCTION

Pediatric convulsive status epilepticus is one of the most common neurologic emergencies and should be managed by health care professionals as soon as possible based on current guidelines. This study aimed to determine the nursing approaches and management of pediatric convulsive status epilepticus from the perspective of emergency nurses in Turkey.

METHODS

A cross-sectional, multicenter study was conducted with 162 emergency nurses working in emergency departments in 35 different provinces in Turkey. The data were collected via an online form. Descriptive statistical methods were used in data analysis.

RESULTS

Most emergency nurses (72.2%) attempted an intravenous access immediately to administer antiseizure medications during the stabilization phase. Approximately half the emergency nurses stated that rectal diazePAM was frequently administered in the initial therapy phase and intravenous diazePAM was administered in the second therapy phase. The emergency nurses had most difficulties attempting intravenous access, determining status epilepticus types, and calming the parents.

DISCUSSION

As health care professionals and important members of the health team, emergency nurses have the responsibility to manage pediatric convulsive status epilepticus in the fastest and the most appropriate way based on current practice guidelines in emergency departments. When intravenous access is not available, nonintravenous benzodiazepines should be considered in the first-line treatment of pediatric convulsive status epilepticus, followed by immediate intravenous access.

摘要

介绍

小儿惊厥性癫痫持续状态是最常见的神经急症之一,应根据当前指南尽快由医护人员进行处理。本研究旨在从土耳其急诊护士的角度确定小儿惊厥性癫痫持续状态的护理方法和管理。

方法

采用横断面、多中心研究,在土耳其 35 个不同省份的急诊部门工作的 162 名急诊护士参与了此项研究。数据通过在线表格收集。数据分析采用描述性统计方法。

结果

大多数急诊护士(72.2%)在稳定期立即尝试进行静脉通路,以给予抗癫痫药物。大约一半的急诊护士表示,在初始治疗阶段经常给予直肠地西泮,而在第二治疗阶段给予静脉地西泮。急诊护士在尝试建立静脉通路、确定癫痫持续状态类型和安抚家长方面遇到了最大的困难。

讨论

作为医护人员和医疗团队的重要成员,急诊护士有责任根据急诊部门的当前实践指南,以最快和最合适的方式管理小儿惊厥性癫痫持续状态。在无法建立静脉通路的情况下,应考虑在小儿惊厥性癫痫持续状态的一线治疗中使用非静脉用苯二氮䓬类药物,随后立即建立静脉通路。

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