血液检查在急诊科患者的初步评估和复苏中是否有价值？
Are blood tests of value in the primary assessment and resuscitation of patients in the A&E department?
作者信息
Pennycook A
机构信息
Accident and Emergency Department, Southampton General Hospital, UK.
出版信息
Postgrad Med J. 1995 Feb;71(832):81-5. doi: 10.1136/pgmj.71.832.81.
Abstract
Over a three month period an audit of the use of emergency blood tests was carried out in the accident and emergency (A&E) department at Southampton General Hospital. Few blood tests were found to be useful in the primary assessment and treatment of patients by the attending doctors. Only cross-matching of blood, an amylase level and an arterial blood gases were felt to be consistently of clinical benefit in the acute management of the patient. The reasons for inappropriate investigations and possible solutions are discussed. Significant cost savings can be made, allowing for better targeting of resources.
摘要
在三个月的时间里，对南安普敦总医院急诊部的急诊血液检查使用情况进行了一次审核。发现主治医生在对患者进行初步评估和治疗时，很少有血液检查被认为是有用的。在对患者的急性处理中，只有血型交叉配血、淀粉酶水平和动脉血气分析被一致认为具有临床益处。文中讨论了不适当检查的原因及可能的解决办法。这样做可以大幅节省成本，使资源得到更合理的配置。
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本文引用的文献
1
Contribution of preoperative investigations to the anaesthetic management of adult trauma patients.术前检查对成年创伤患者麻醉管理的作用。
Injury. 1993;24(1):17-20. doi: 10.1016/0020-1383(93)90075-h.
2
Evaluation of laboratory tests in hospitals.医院实验室检查的评估。
Ann Clin Biochem. 1980 Nov;17(6):281-6. doi: 10.1177/000456328001700601.
3
Do emergency tests help in the management of acute medical admissions?急诊检查对急性内科住院患者的管理有帮助吗？
Br Med J (Clin Res Ed). 1984 Oct 13;289(6450):973-7. doi: 10.1136/bmj.289.6450.973.
4
Strategies to modify the test-requesting patterns of clinicians.改变临床医生检验申请模式的策略。
Ann Clin Biochem. 1987 May;24 ( Pt 3):223-31. doi: 10.1177/000456328702400301.
5
Trial of strategy for reducing the use of laboratory tests.减少实验室检查使用策略的试验
Br Med J (Clin Res Ed). 1986 Mar 29;292(6524):883-5. doi: 10.1136/bmj.292.6524.883.
6
Improving laboratory usage: a review.改善实验室使用情况：综述
Postgrad Med J. 1988 Apr;64(750):283-9. doi: 10.1136/pgmj.64.750.283.
7
Rational restriction of out of hours requests for haematology tests.合理限制非工作时间的血液学检查请求。
BMJ. 1989 May 13;298(6683):1291-2. doi: 10.1136/bmj.298.6683.1291.
8
The on-call service: a regional survey.随叫随到服务：一项区域调查。
Ann Clin Biochem. 1989 Jan;26 ( Pt 1):19-25. doi: 10.1177/000456328902600103.
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