Reducing the risks of intrahospital transport among critically ill patients*.
Reducing the risks of intrahospital transport among critically ill patients*.
复制标题
降低危重患者院内转运的风险*。
DOI：
10.1097/ccm.0b013e31828fd714
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发表时间：
2013
影响因子：
8.8
通讯作者：
Nuckols,TerylK
中科院分区：
文献类型：
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作者：
Nuckols,TerylK
实习六周后，我和同学在查房后一起吃早餐。我们听到头顶有蓝色警报;是在CT扫描仪里。“死亡始于放射科，”她建议我，脸上的表情就像实习生所能看到的那样睿智。“事实证明，临床恶化往往始于那里或途中。”几天前，她自己也需要打电话给麻醉师，以便在扫描仪中紧急重新给一个病人插管我们在值班时间限制和专门的运输护士之前接受了培训。几项研究表明，在医院周围移动危重病人，特别是到偏远和人员稀少的诊断单位，与不良后果有关，包括死亡（1）。然而，研究人员面临的挑战是解开运输是否会导致并发症，与严重疾病相关的症状是否会导致需要运输，或者严重疾病是否会导致需要运输和并发症。用研究术语来说，这个鸡和蛋的问题被称为内分泌。
Six weeks into internship, my classmate and I were having breakfast together after rounds. We heard a code blue called overhead; it was in the CT scanner.“Death begins in Radiology,” she advised me with as sage a look as an intern can visage.“It was been proven that clinical deterioration often begins there or en route.” She herself had needed to call anesthesia to emergently reintubate a patient in the scanner just days earlier—we trained before duty-hour limits and dedicated transport nurses.Despite her penchant for making dramatic statements, my classmate, now friend, was right. Several studies have shown that moving critically ill patients around the hospital, particularly to remote and sparsely staffed diagnostic units, is associated with adverse outcomes, including death (1). Yet, the challenge for researchers is untangling whether being transported causes complications, symptoms related to severe illness induce a need to be transported, or severe illness leads to both a need for transport and complications. This chicken-and-egg issue is called, in research parlance, endogeneity.