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BMJ Global Health:减少危重病死亡的40个简单步骤

2021-09-22 MedSci原创 MedSci原创

挽救生命的护理方案!

急危重症通常表示患者所得疾病为某种紧急、濒危的病症,应当尽早进行医学处理,否则可能对患者身体产生重度伤害或导致死亡。据数据显示,每年因任何形式的严重的急性疾病而导致死亡的人数超数百万。

然而,许多因重大疾病而导致的死亡是可以预防的。在危重疾病中,患者的气道、呼吸或循环可能会受到损害,早期发现问题并及时护理可以挽救生命。不幸的是,急危重症护理常常被忽视。近日,发表在 BMJ Global Health杂志的一项研究,概述了适用于所有危重患者的一系列基线护理干预措施,包括 COVID-19

在这项研究中,通过基本急诊和重症监护 EECC)描述了一套在全球所有医院环境中都应该可行的治疗方法和行动。这些是低复杂性和低成本的挽救生命的做法,来自近 60 个国家的 250 多位临床专家一致认为这将使危重患者受益。

EECC由来自中高收入和低收入国家的一系列医学专家组成的专家小组对一系列拟定的治疗进行评级,这些治疗改编自世界卫生组织的基本急救指南。经过三轮,达成了超过 90% 专家的共识,从而形成了 40 项临床流程和 67 项医院准备要求的一套方案,另外还有针对 COVID-19的护理。

EECC主要包括:

1)通过定期评估脉搏、血氧饱和度和血压等生命体征来识别危重疾病。

2)对呼吸困难、循环受损或意识水平降低的患者,使用简单的方法(如身体定位、氧疗和静脉输液)护理气道。

 

3)促进安全和正常工作的方案流程,例如沟通实践和传染病患者的隔离。

4)医院需要具备识别和护理危重病人所需的物品清单,包括设备、消耗品、药品、培训、基础设施等。

 

5)关于护理危重 COVID-19 患者,包括监测血氧饱和度、使用肝素和皮质类固醇。另外,医务人员需要接受COVID-19危重病人基本护理的培训。

总之,基本急诊和重症监护(EECC)是一种低成本、低复杂性的有效挽救生命的护理,全球所有医院的所有病房内所有重症患者都应接受这种护理。

原始出处

Carl Otto Schell et al, Essential Emergency and Critical Care: a consensus among global clinical experts, BMJ Global Health (2021). DOI: 10.1136/bmjgh-2021-006585

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    2022-05-03 gaoxiaoe
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    2021-12-21 shizhenshan
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1690487, encodeId=ad93169048e71, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Wed Jul 06 22:53:45 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849308, encodeId=d7be1849308e3, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue May 03 10:53:45 CST 2022, time=2022-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861472, encodeId=4e2618614e216, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Tue Dec 21 03:53:45 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621929, encodeId=2d811621929c5, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Sep 24 06:53:45 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1054038, encodeId=8d1f1054038b6, content=很棒的学习软件, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2f255526204, createdName=我思故我在2, createdTime=Thu Sep 23 08:27:46 CST 2021, time=2021-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053844, encodeId=e3a1105384407, content=支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLtjqoUNGKOVUWGMj10w1LRueMf9pia7E5fuYN9IqHxCRVPugZ2PjBEpwpgNLj9f0sHdfFo7fyXXHQ/132, createdBy=31102132202, createdName=1521fcfae0m, createdTime=Wed Sep 22 16:40:14 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053839, encodeId=a1a5105383905, content=一篇好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:29:27 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053836, encodeId=aefd1053836c4, content=号文, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:24:31 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-23 我思故我在2

    很棒的学习软件

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1690487, encodeId=ad93169048e71, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Wed Jul 06 22:53:45 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849308, encodeId=d7be1849308e3, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue May 03 10:53:45 CST 2022, time=2022-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861472, encodeId=4e2618614e216, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Tue Dec 21 03:53:45 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621929, encodeId=2d811621929c5, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Sep 24 06:53:45 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1054038, encodeId=8d1f1054038b6, content=很棒的学习软件, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2f255526204, createdName=我思故我在2, createdTime=Thu Sep 23 08:27:46 CST 2021, time=2021-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053844, encodeId=e3a1105384407, content=支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLtjqoUNGKOVUWGMj10w1LRueMf9pia7E5fuYN9IqHxCRVPugZ2PjBEpwpgNLj9f0sHdfFo7fyXXHQ/132, createdBy=31102132202, createdName=1521fcfae0m, createdTime=Wed Sep 22 16:40:14 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053839, encodeId=a1a5105383905, content=一篇好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:29:27 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053836, encodeId=aefd1053836c4, content=号文, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:24:31 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-22 1521fcfae0m

    支持

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1690487, encodeId=ad93169048e71, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Wed Jul 06 22:53:45 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849308, encodeId=d7be1849308e3, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue May 03 10:53:45 CST 2022, time=2022-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861472, encodeId=4e2618614e216, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Tue Dec 21 03:53:45 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621929, encodeId=2d811621929c5, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Sep 24 06:53:45 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1054038, encodeId=8d1f1054038b6, content=很棒的学习软件, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2f255526204, createdName=我思故我在2, createdTime=Thu Sep 23 08:27:46 CST 2021, time=2021-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053844, encodeId=e3a1105384407, content=支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLtjqoUNGKOVUWGMj10w1LRueMf9pia7E5fuYN9IqHxCRVPugZ2PjBEpwpgNLj9f0sHdfFo7fyXXHQ/132, createdBy=31102132202, createdName=1521fcfae0m, createdTime=Wed Sep 22 16:40:14 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053839, encodeId=a1a5105383905, content=一篇好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:29:27 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053836, encodeId=aefd1053836c4, content=号文, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:24:31 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-22 橘子熟了1

    一篇好的文章

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1690487, encodeId=ad93169048e71, content=<a href='/topic/show?id=fdb336e49bb' target=_blank style='color:#2F92EE;'>#危重病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36749, encryptionId=fdb336e49bb, topicName=危重病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=27f729051889, createdName=xinmeili, createdTime=Wed Jul 06 22:53:45 CST 2022, time=2022-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1849308, encodeId=d7be1849308e3, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Tue May 03 10:53:45 CST 2022, time=2022-05-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1861472, encodeId=4e2618614e216, content=<a href='/topic/show?id=401a23e102' target=_blank style='color:#2F92EE;'>#ALT#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2371, encryptionId=401a23e102, topicName=ALT)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Tue Dec 21 03:53:45 CST 2021, time=2021-12-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1621929, encodeId=2d811621929c5, content=<a href='/topic/show?id=5f1386329e' target=_blank style='color:#2F92EE;'>#Health#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8632, encryptionId=5f1386329e, topicName=Health)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8d2020283215, createdName=yyanpro@28cn.c, createdTime=Fri Sep 24 06:53:45 CST 2021, time=2021-09-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1054038, encodeId=8d1f1054038b6, content=很棒的学习软件, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=2f255526204, createdName=我思故我在2, createdTime=Thu Sep 23 08:27:46 CST 2021, time=2021-09-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053844, encodeId=e3a1105384407, content=支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLtjqoUNGKOVUWGMj10w1LRueMf9pia7E5fuYN9IqHxCRVPugZ2PjBEpwpgNLj9f0sHdfFo7fyXXHQ/132, createdBy=31102132202, createdName=1521fcfae0m, createdTime=Wed Sep 22 16:40:14 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053839, encodeId=a1a5105383905, content=一篇好的文章, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:29:27 CST 2021, time=2021-09-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1053836, encodeId=aefd1053836c4, content=号文, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210825/bf71ce23285843e7b12f8e0ee72b9140/a2c40c77a69043f8955506ac0cfca1e7.jpg, createdBy=fe545584737, createdName=橘子熟了1, createdTime=Wed Sep 22 16:24:31 CST 2021, time=2021-09-22, status=1, ipAttribution=)]
    2021-09-22 橘子熟了1

    号文

    0

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