摘要
目的通过分析体外膜肺氧合(ECMO)支持危重患者转运的不良事件发生的原因及特点,探讨如何避免不良事件的发生,为提高ECMO患者转运安全和制订相应防范措施提供依据。方法应用自行设计的ECMO患者转运观察表格收集数据,回顾性研究2013年1月至2017年6月北京朝阳医院ECMO团队实施ECMO患者转运的患者不良事件的发生率,根据不良事件的发生的原因和对患者可能造成的危险进行分类分析,从而提出可行的预防措施。结果共实施53例ECMO患者转运,不良事件共发生18例占33.96%,其中院内转运不良事件的发生率为34.21%(13/38),院际转运发生率为33.33%(5/15),在ECMO患者转运中无患者死亡。在ECMO患者转运发生的不良事件中,发生的原因主要与转运人员、转运设备和患者相关,各占1/3;其中用物不全4例占22.22%和蓄电池、电源问题3例占16.67%,这两种不良事件最为突出;按对患者造成的危险度分类,3级危险度的不良事件6例占33.33%。结论基于我院ECMO患者转运团队和转运流程实施ECMO院内转运和院际转运是安全可行的。但ECMO患者转运中发生高风险或危及生命的突发不良事件是不可避免的。通过对ECMO团队规范培训,转运前进行充分评估,使用ECMO患者转运核查单,并严格执行各项转运流程及规范,可能会降低ECMO患者转运的不良事件的发生率。
Objective To discuss how to avoid the occurrence of adverse events and provides basis for improving the extracorporeal membrane oxygenation(ECMO)transport safety management to formulate the corresponding preventive measures through analyzing the causes and characteristics of adverse events in transport of ECMO.Methods By using a self-designed ECMO transport observation table to collect data,with a retrospective study of adverse events in patients with ECMO transport in ECMO center of Beijing Chaoyang Hospital from January 2013 to June 2017,carrying out classification and analysis according to the causes of adverse events and the potential risks of the patients,thus put forward the feasible preventive measures.Results There were 53 cases of ECMO transport in study period,with 18 cases(33.96%)of adverse events,among which the incidence of adverse events in inner-hospital transport was 34.21%(13/38)and that in inter-hospital transport was 33.33%(5/15).There was no patient died in ECMO transport.In the adverse events of ECMO transport,the main causes were related to transport staff,transport equipment and patient,which accounting for 1/3 of each.Among them,the most prominent was 4 cases(22.22%)of equipment lacking and 3 cases of battery and power supply(16.67%).In classification according to the risk degree of patients,6 cases(33.33%)of third grade risk were found.Conclusions It is safe and feasible to carry out ECMO transport in inner-hospital transport and inter-hospital transport based on ECMO transport team and transport process of this hospital.However the unexpected events of high risk or crisis of life is inevitable in ECMO transport.Through standardized training for ECMO team,with full assessment before transport,by the use of ECMO checklist and strict implementation of various transport processes and specifications,the incidence of adverse events in ECMO transport may be reduced.
作者
王淑芹
孙兵
张春艳
万娜
李绪言
唐晓
贺航咏
王睿
贾燕瑞
童朝晖
Wang Shuqin;Sun Bing;Zhang Chunyan;Wan Na;Li Xuyan;Tang Xiao;He Hangyong;Wang Rui;Jia Yanrui;Tong Zhaohui(Respiratory and Critical Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中国实用护理杂志》
2020年第27期2124-2128,共5页
Chinese Journal of Practical Nursing
关键词
体外膜肺氧合
转运
危重患者
不良事件
Extracorporeal membrane oxygenation
Transport
Critical patients
Adverse events
