急诊创伤患者低体温院内评估处置现况调查
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军队医学科技老年培育计划护理项目(19QNP077);南京军区医药卫生科研基金课题(12MA088)


Investigation on intra-hospital assessment and management of hypothermia by medical staff working in emergency department for trauma patients
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    摘要:

    目的 调查急诊创伤患者低体温院内评估处置现状,为规范临床创伤患者的管理提供参考。方法 采用自制创伤低体温救治 问卷对42所医院急诊科的230名医护人员进行调查。结果 42所医院中17所创建了创伤中心;调查对象中分别有29.13%、 17.39%的医护人员会对患者进行创伤修正评分、损伤严重评分;39.57%的医护人员会测量创伤患者的耳温,5.22%的医护人员 会根据患者情况选择测量频率,14.78% 的医护人员会对血压 <90 mmHg的患者进行体温的监测;分别有 13.48%、6.96%、 25.22%的医护人员会使用升温毯、电热毯、加温输液给创伤低体温患者进行复温;是否成立创伤中心的医院在低体温评估、体温 监测及复温措施方面比较,差异有统计学意义(P<0.05,P<0.01)。结论 急诊创伤患者低体温的评估、监测、复温情况均不容乐 观,管理者应积极引进有效的设备运用于临床,同时积极开展关于低体温相关知识的培训,以提高护理人员的创伤低体温认知水 平,完善创伤患者低体温的救治管理。

    Abstract:

    Objective To investigate the present situation of evaluation and management of hypothermia in hospital for emergency trauma patients, so as to provide reference for standardizing the management of clinical trauma patients. Methods A total of conve-nience sampling was carried out in 42 hospitals and 230 medical staff members working in emergency department were investigated by using a self-made questionnaire. Results Among the 42 hospitals, 17 has established a trauma center. Among the medical staff, 29.13% and 17.39% would evaluate the patients with Revised Trauma Score and Injury Severity Scale respectively; 39.57% of the medical staff would measure the ear temperature of trauma patients, 5.22% reported the measurement was based on patient′s condition individually; 14.78% would monitor the temperature of patients with blood pressure <90 mmHg; 13.48%, 6.96% and 25.22%would use heating blanket, electric blanket, heated fluid to rewarm the patients with hypothermia after trauma, respectively. There were significant differences in hypothermia assessment, temperature monitoring and active rewarming between hospitals with a trauma center and those without (P<0.05,P<0.01). Conclusion The situation of hypothermia assessment, temperature monitoring and rewarming in trauma patients is less satisfactory.Managers should actively introduce effective equipment and actively carry out trainings on hypothermia, so as to improve knowledge level of nurses about hypothermia, and to improve the treatment and management of hypothermia of trauma patients.

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涂加园,孙琳,黄萍,聂时南,刘云,韩小琴,赵泽华.急诊创伤患者低体温院内评估处置现况调查[J].护理学杂志,2019,34(7):15-18

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  • 收稿日期:2018-11-15
  • 最后修改日期:2019-02-02
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  • 在线发布日期: 2022-08-09