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药剂师参与心脏骤停和创伤复苏的临床结果:一项范围综述。

Clinical Outcomes of Pharmacist Involvement in Cardiac Arrest and Trauma Resuscitations: A Scoping Review.

作者信息

Patel Harshita, Wee Myles, Tejani Aaron M, Lau Anthony

机构信息

Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.

Lower Mainland Pharmacy Services, Fraser Health Authority, Vancouver, BC V2Y 0A1, Canada.

出版信息

Pharmacy (Basel). 2025 Jun 24;13(4):89. doi: 10.3390/pharmacy13040089.

Abstract

BACKGROUND

The role of clinical pharmacists in the emergency department continues to gain recognition, particularly during cardiac and trauma resuscitations. However, their contributions to patient outcomes remain unclear. The objective of this scoping review with narrative synthesis was to determine the impact of pharmacists on medication and patient outcomes during cardiac and trauma resuscitations and to identify barriers to integration.

METHODS

A literature search of databases in September 2024 identified randomized and non-randomized control trials, evaluating the impact of pharmacists' involvement in cardiac or trauma resuscitations. Excluded were studies on acute stroke, acute hemorrhage, and sepsis. Data were extracted and analyzed for primary (e.g., medication errors and Advanced Cardiovascular Life Support [ACLS] compliance) and secondary outcomes (e.g., pharmacists' education and training).

RESULTS

Of the 560 records screened, 26 records were included in the final analysis. Due to heterogeneity, quantitative analysis was not feasible. Among primary outcomes, ACLS guideline compliance and medication errors were commonly reported; mortality and length of stay were less commonly reported. ACLS certification improved pharmacists' confidence in their tasks. Pharmacists' presence also correlated with reduced healthcare costs.

CONCLUSIONS

Our analysis suggests that the involvement of pharmacists in the context of emergency cardiac or trauma resuscitations may benefit direct patient outcomes and indirect outcomes.

摘要

背景

临床药师在急诊科的作用日益得到认可,尤其是在心脏和创伤复苏期间。然而,他们对患者预后的贡献仍不明确。本项带有叙述性综合分析的范围综述的目的是确定药师在心脏和创伤复苏期间对用药及患者预后的影响,并找出整合的障碍。

方法

2024年9月对数据库进行文献检索,确定了评估药师参与心脏或创伤复苏影响的随机和非随机对照试验。排除了关于急性中风、急性出血和脓毒症的研究。提取并分析了主要结局(如用药错误和高级心血管生命支持[ACLS]依从性)和次要结局(如药师的教育和培训)的数据。

结果

在筛选的560条记录中,最终分析纳入了26条记录。由于存在异质性,定量分析不可行。在主要结局中,ACLS指南依从性和用药错误是常见报告内容;死亡率和住院时间的报告较少。ACLS认证提高了药师对其任务的信心。药师的在场也与医疗成本降低相关。

结论

我们的分析表明,药师参与紧急心脏或创伤复苏可能有益于直接患者结局和间接结局。

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