急诊成人创伤患者自发性低体温院内管理的最佳证据总结

doi:10.3761/j.issn.2096-7446.2022.06.006

摘要/Abstract

摘要： 目的检索、评价并整合急诊成人创伤患者自发性低体温院内管理的最佳证据,为临床实践提供参考。方法计算机检索BMJ Best Practice、UpToDate、Cochrane Library、澳大利亚乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健国际合作中心图书馆、国际指南协作网等临床实践指南网站、美国急症护理协会等专业协会网站、PubMed、Embase、CINAHL、Web of Science、中国知网、万方数据库、中国生物医学文献数据库中与创伤低体温有关的指南、专家共识、系统评价、证据总结、临床决策、最佳实践。检索时限为建库至2021年12月31日。由2名研究者对文献进行质量评价后,对符合质量标准的文献进行证据的提取、归类综合并评定其等级及推荐级别。结果共纳入15篇文献,包括最佳实践1篇、临床决策2篇、指南5篇、专家共识1篇、证据总结5篇、系统评价1篇。从创伤低体温的相关概念、体温监测、体温管理原则、复温措施、复温注意事项、复温评估、转运管理及质量管理8个方面总结出27条最佳证据。结论该研究总结了急诊成人创伤患者自发性低体温院内管理的最佳证据,可结合医院特点和临床环境,形成急诊成人创伤患者的体温管理方案,以提高急诊创伤患者自发性低体温院内管理的规范性。

关键词: 急诊室,医院, 创伤和损伤, 低体温, 循证护理学

Abstract: Objective To search,evaluate and integrate the best evidence for in-hospital management of spontaneous hypothermia in emergency adult trauma patients to provide a reference for clinical practice. Methods BMJ-BestPractice,UpToDate,Cochrane Library,Joanna Briggs Institute Library,the clinical practice guideline websites such as International Guidelines Collaboration,professional association websites such as American Association of Acute Care,PubMed,Embase,CINAHL,Web of Science,China Knowledge Infrastructure,Wanfang Database,and Chinese Biomedical Literature Database were searched for guidelines,expert consensus,systematic review,evidence summary,clinical decision-making,and best practice related to traumatic hypothermia. The search period was from database establishment to December 31,2021. After evaluating the quality of literatures,two researchers carried out the extraction,classification and synthesis of evidence and evaluate the grade and recommendation grade. Results A total of 15 articles were included,including one best practice,two clinical decisions,five guidelines,one expert consensus,five evidence summaries,and one systematic review. Totally 27 pieces of evidence were summarized from eight aspects：the related concepts of traumatic hypothermia,body temperature monitoring,body temperature management principles,rewarming measures,rewarming precautions,rewarming assessment,transport management and quality management. Conclusion This study summarized the best evidence for in-hospital management of spontaneous hypothermia in emergency adult trauma patients,the body temperature management program for emergency adult trauma patients can be formed according to the contents of the best evidence and combined with the characteristics of the hospital and the clinical environment,so as to improve the standardization of in-hospital hypothermia management in trauma patients.

Key words: Emergency Service,Hospital, Wounds and Injuries, Hypothermia, Evidence-Based Nursing

吴金玉, 帅俊坤, 上官非凡, 方桂珍. 急诊成人创伤患者自发性低体温院内管理的最佳证据总结[J]. 中华急危重症护理杂志, 2022, 3(6): 513-519.

WU Jinyu, SHUAI Junkun, SHANGGUAN Feifan, FANG Guizhen. Summary of best evidence for in-hospital management of spontaneous hypothermia in emergency adult trauma patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022, 3(6): 513-519.

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