Johnson G S, Guly H R
Accident and Emergency Department, Derriford Hospital, Plymouth, UK.
J Accid Emerg Med. 1995 Mar;12(1):20-2. doi: 10.1136/emj.12.1.20.
The use of intravenous nalbuphine in pre-hospital settings by paramedics has been demonstrated to be safe and effective. We assessed the effect of this additional intervention by comparing the time spent on-scene by ambulance crews treating patients with fractures of the tibia and fibula who received intravenous nalbuphine with those who had placement of an intravenous cannula alone and those who had neither cannula nor nalbuphine. The mean on-scene times were 17.1 min without cannulation, 29.9 min for cannulation without nalbuphine and 37.5 min for cannulation and administration of nalbuphine. The benefits of effective pre-hospital analgesia thus have a cost in terms of time. Continued audit of interventions and on-scene times is important to prevent inappropriate delays in pre-hospital care which may cause clinical and operational problems.
护理人员在院前环境中使用静脉注射纳布啡已被证明是安全有效的。我们通过比较救护车工作人员治疗胫腓骨骨折患者的现场停留时间来评估这种额外干预措施的效果，这些患者中有的接受了静脉注射纳布啡，有的只放置了静脉套管，还有的既没有套管也没有纳布啡。无套管时的平均现场停留时间为17.1分钟，有套管但未使用纳布啡时为29.9分钟，有套管且使用纳布啡时为37.5分钟。因此，有效的院前镇痛在时间方面是有代价的。持续审核干预措施和现场停留时间对于防止院前护理中可能导致临床和操作问题的不适当延误很重要。
