Safety Considerations and Guideline-Based Safe Use Recommendations for "Bolus-Dose" Vasopressors in the Emergency Department
Safety Considerations and Guideline-Based Safe Use Recommendations for "Bolus-Dose" Vasopressors in the Emergency Department
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DOI：
10.1016/j.annemergmed.2017.04.021
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发表时间：
2018-01-01
影响因子：
6.2
通讯作者：
Lesar, Timothy
中科院分区：
文献类型：
--
作者：
Holden, Devin;Ramich, Jessica;Lesar, Timothy
在急诊室（艾德）使用间歇给药的血管加压药来纠正低血压，通常称为推注剂量加压药、推注剂量加压药、Neo-sticks或苯基棒。在传统的印刷医学文献之外被广泛提倡。目前尚无该实践的结局数据证明其优于传统的血管加压药持续输注。在艾德环境中使用大剂量血管加压药引起了许多患者安全性问题，大剂量血管加压药的制备和给药中的误用和错误可能导致患者伤害。如果使用大剂量血管加压药，应实施基于系统的方法，以最大限度地提高安全性和患者获益。本文讨论了在评价大剂量血管加压药在艾德中的作用时需要考虑的广泛问题，并根据当前的安全用药实践指南提供了建议。
The use of intermittently administered doses of vasopressors to correct hypotension in the emergency department (ED), commonly referred to as bolus-dose pressors, push-dose pressors, Neo-sticks, or phenyl sticks, has. been widely advocated outside of the traditional printed medical literature. No outcomes data of this practice exist to demonstrate benefits over traditional continuous infusion of vasopressors. Use of bolus-dose vasopressors in the ED setting raises a number of patient safety concerns, and misuse and errors in the preparation and administration of bolus-dose vasopressors may result in patient harm. A systems-based approach should be implemented to maximize safety and patient benefits if bolus-dose vasopressors are used. This article discusses the wide range of issues to consider when evaluating the role of bolus-dose vasopressors in the ED and provides recommendations based on current safe medication practices guidelines.