Stroke:儿童动脉缺血性卒中的院前急救护理如何?

2017-02-25 xing.T MedSci原创

由此可见,急救医疗服务电话接线员和卫生保健辅助人员诊断的敏感性和预先通知率在儿童AIS患者中较低。

立即呼叫救护车是缩短成年卒中患者到医院就诊时间的关键因素。然而,对于儿童动脉缺血性卒中(AIS)的院前急救鲜为人知。近日,卒中领域权威杂志Stroke上发表了一篇研究文章,研究人员的目的是确定急救医疗服务电话接线员和卫生保健辅助人员诊断的敏感度,并且描述儿童AIS患者的护理时间线。

这是一项救护车运送年龄小于18岁第一影像治疗证实为AIS儿童的回顾性研究,时间从2008年到2015年。之前诊断的AIS并进行院内转送的儿童将被排除在外。

研究人员确定了23名儿童,其中4名患者因救护车记录不可用而被排除。19名儿童被纳入该研究。他们的年龄中位数为8岁(四分位间距为3-14岁);儿童国立脑卒中严重程度评分的中位数为8分(四分位间距为3-16分)。急救医疗服务电话接线员诊断为脑卒中的儿童有4例(21%)。优先编码1(灯和警报器)救护车派出运送13名儿童(68%)。卫生保健辅助人员诊断为脑卒中的儿童有5例(26%),医院预先通知的发生卒中的儿童有8例(42%),并且有13名儿童(68%)被运送到初级卒中中心。院前时间线从发病到急救医疗服务接触中位时间为13min,从打电话到医疗人员到场为12min,现场处置时间为14min,运输时间为43min,总的院前时间为71分钟(间距范围为60-85min)。

由此可见,急救医疗服务电话接线员和卫生保健辅助人员诊断的敏感性和预先通知率在儿童AIS患者中较低。        

原始出处:

Belinda Stojanovski, et al. Prehospital Emergency Care in Childhood Arterial Ischemic Stroke.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.116.014768

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