ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会
指南与标准

急诊室创伤复苏单元护理管理专家共识

  • 中华护理学会急诊护理专业委员会 ,
  • 浙江大学医学院附属第二医院护理部/急诊医学科 ,
  • (执笔:王飒 ,王钰炜, 闫丹萍, 武作家, 封秀琴, 兰美娟, 金静芬)
展开
  • 310009 杭州市 浙江大学医学院附属第二医院护理部(王飒,封秀琴,兰美娟,金静芬),急诊医学科(王钰炜,闫丹萍,武作家)
王飒:女,硕士,副主任护师,E-mail:2506025@zju.edu.cn

收稿日期: 2025-01-06

  网络出版日期: 2025-07-04

基金资助

浙江省医药卫生科技计划项目(2023KY739)

Expert consensus on nursing management of trauma resuscitation units in emergency rooms

  • Emergency Nursing Committee of Chinese Nursing Association ,
  • Department of Nursing/Department of Emergency,The Second Affiliated Hospital,Zhejiang University School of Medicine ,
  • (Writing Committee:WANG Sa,WANG Yuwei,YAN Danping,WU Zuojia,FENG Xiuqin,LAN Meijuan,JIN Jingfen)
Expand

Received date: 2025-01-06

  Online published: 2025-07-04

摘要

目的 制订急诊室创伤复苏单元护理管理专家共识,为规范创伤中心护理管理、提升严重创伤护理救治水平提供参考。 方法 根据前期研究及创伤单元建设需求分析,参考国内外近10年创伤复苏单元建设与护理管理研究、指南、共识及临床实践,基于循证分析,通过德尔菲专家函询,形成共识终稿。 结果 共识内容包括创伤复苏单元概念界定、创伤复苏单元的配置与功能、创伤复苏单元护理基本功能建设与管理、创伤护理团队建设与管理、创伤护理制度建设与管理等5个方面31条推荐意见,25条A级推荐,6条B级推荐。 结论 该共识具有科学性和实用性,可为急诊室创伤复苏单元护理管理提供实践指导。

本文引用格式

中华护理学会急诊护理专业委员会 , 浙江大学医学院附属第二医院护理部/急诊医学科 , (执笔:王飒 ,王钰炜, 闫丹萍, 武作家, 封秀琴, 兰美娟, 金静芬) . 急诊室创伤复苏单元护理管理专家共识[J]. 中华急危重症护理杂志, 2025 , 6(7) : 830 -836 . DOI: 10.3761/j.issn.2096-7446.2025.07.010

Abstract

Objective To formulate the expert consensus on nursing management of trauma resuscitation units in emergency rooms,providing a reference for standardizing trauma center nursing management and improving the quality of care for severe trauma patients. Methods Based on previous research and an analysis of the needs for trauma unit development,this consensus was developed by reviewing domestic and international studies,guidelines,expert consensus,and clinical practices related to trauma resuscitation unit construction and nursing management over the past ten years. An evidence-based analysis was conducted,and the final consensus was established through a Delphi expert consultation process. Results The consensus consists of 31 recommendations in five key areas,including definition of concepts,configuration and functions of the trauma resuscitation unit,construction and management of basic functions in trauma resuscitation units,construction and management of trauma nursing teams,and development and management of trauma nursing systems. Among these,there were 25 recommendations with Grade A,and 6 with Grade B. Conclusion This consensus is scientific and practical,and it provides guidance for the nursing management of trauma resuscitation units in trauma centers.

参考文献

[1] 中华人民共和国统计局. 中国统计年鉴[M]. 北京: 中国统计出版社, 2023.
  National Bureau of Statistics of the People’s Republic of China. China Statistical Yearbook[M]. Beijing: China Statistics Press, 2023.
[2] 周靖, 王天兵, 姜保国. 中国创伤救治体系的现状与发展[J]. 中华外科杂志, 2022, 60(12):1045-1048.
  Zhou J, Wang TB, Jiang BG. Current situation and development of Chinese trauma care system[J]. Chin J Surg, 2022, 60(12):1045-1048.
[3] Weihs V, Frenzel S, Dedeyan M, et al. 25-Year experience with adult polytraumatized patients in a European level 1 trauma center:polytrauma between 1995 and 2019. What has changed? A retrospective cohort study[J]. Arch Orthop Trauma Surg, 2023, 143(5):2409-2415.
[4] 章桂喜, 张连阳. 规范建设创伤复苏单元[J]. 创伤外科杂志, 2022, 24(3):161-165.
  Zhang GX, Zhang LY. Standardizing the construction of trauma resuscitation unit[J]. J Trauma Surg, 2022, 24(3):161-165.
[5] Rossaint R, Bouillon B, Cerny V, et al. The European guideline on management of major bleeding and coagulopathy following trauma:fourth edition[J]. Crit Care, 2016, 20:100.
[6] Apfelbaum JL, Hagberg CA, Connis RT, et al. 2022 American society of anesthesiologists practice guidelines for management of the difficult airway[J]. Anesthesiology,2022, 136(1):31-81.
[7] Jenkins JL, Hsu EB, RussellA , et al. Infection prevention and control for the emergency medical services and 911 workforce[M]. Rockville(MD): Agency for Healthcare Research and Quality(US), 2022.
[8] 中国城市创伤救治体系建设标准专家共识专家组. 中国城市创伤救治体系建设标准专家共识(2024年版)[J]. 中华骨科杂志, 2024, 44(1):1-5.
  Expert Group of Expert Consensus on the Construction Standards for China’s Urban Trauma Treatment System. Expert consensus on the construction standards for urban trauma treatment system in China(2024 edition)[J]. Chin J Orthop, 2024, 44(1):1-5.
[9] 中国人民解放军急救医学专业委员会, 中国医师协会急诊医师分会, 北京急诊医学学会, 等. 创伤失血性休克中国急诊专家共识(2023)[J]. 中国急救医学, 2023, 43(11):841-854.
  Emergency Medicine Committee of the People’s Liberation Army,Emergency Doctor Branch of Chinese Medical Doctor Association, Beijing Society for Emergency Medicine, et al. Expert consensus on the diagnosis and treatment of traumatic hemorrhagic shock in China(2023)[J]. Chin J Crit Care Med, 2023, 43(11):841-854.
[10] 王飒, 封秀琴, 张茂, 等. 骨髓腔输液通路临床应用护理专家共识[J]. 中华急危重症护理杂志, 2020, 1(4):362-370.
  Wang S, Feng XQ, Zhang M, et al. Expert consensus on nursing clinical application of intraosseous infusion access[J]. Chin J Emerg Crit Care Nurs, 2020, 1(4):362-370.
[11] 王飒, 陈水红, 金静芬, 等. 创伤性低体温患者不同复温措施效果的网状Meta分析[J]. 中华护理杂志, 2017, 52(7):840-844.
  Wang S, Chen SH, Jin JF, et al. Effects of rewarming interventions in hypothermia trauma patients:a network meta-analysis[J]. Chin J Nurs, 2017, 52(7):840-844.
[12] 张阳春, 刘扣英, 张丽, 等. 创伤团队启动标准在急诊预检分诊中识别严重创伤患者准确性的Meta分析[J]. 中国护理管理, 2021, 21(5):728-734.
  Zhang YC, Liu KY, Zhang L, et al. Diagnostic value of trauma team activation criteria for patients with severe trauma in the emergency department triage:a Meta-analysis[J]. Chin Nurs Manag, 2021, 21(5):728-734.
[13] 吴金玉, 帅俊坤, 上官非凡, 等. 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 JY, Shuai JK, Shangguan FF, et al. Summary of best evidence for in-hospital management of spontaneous hypothermia in emergency adult trauma patients[J]. Chin J Emerg Crit Care Nurs, 2022, 3(6):513-519.
[14] El-Menyar A, Ahmed K, Hakim S, et al. Efficacy and safety of the second in-hospital dose of tranexamic acid after receiving the prehospital dose:double-blind randomized controlled clinical trial in a level 1 trauma center[J]. Eur J Trauma Emerg Surg, 2022, 48(4):3089-3099.
[15] Wang S, Chen SH, Jin JF, et al. The effect of trauma advanced practice nurse programme at a Level I regional trauma centre in mainland China[J]. Nurs Open, 2023, 10(9):6559-6565.
[16] Hardway J, Samanta D, Rennie KV, et al. Trauma bay time clocks:influence on emergency department length of stay[J]. J Trauma Nurs, 2021, 28(4):269-274.
[17] 费杏珍, 潘慧斌, 包芸, 等. 院前急救全程信息化管理软件的应用对严重创伤院内急诊救治质控时间的影响分析[J]. 中华急诊医学杂志, 2024, 33(1):115-118.
  Fei XZ, Pan HB, Bao Y, et al. Analysis of the impact of the application of full-process information management software for pre-hospital emergency care on the quality control time of in-hospital emergency treatment for severe trauma[J]. Chin J Emerg Med, 2024, 33(1):115-118.
[18] 丁幼芽, 王钰炜, 闫丹萍, 等. 大剂量输血程序改进及在失血性休克患者中的应用[J]. 中华护理杂志, 2023, 58(21):2604-2609.
  Ding YY, Wang YW, Yan DP, et al. Improvement of high dose blood transfusion procedure and its application in the treatment of patients with traumatic hemorrhagic shock[J]. Chin J Nurs, 2023, 58(21):2604-2609.
[19] 刘皖娟, 姚梅琪, 叶健晓, 等. 创伤护理团队结构化岗位设置对护理人力成本和救治成功率的影响[J]. 护理与康复, 2021, 20(6):62-65.
  Liu WJ, Yao MQ, Ye JX, et al. Influence of structural post setting in traumatic nursing group on nursing resource cost and success rate of saving[J]. J Nurs Rehabil, 2021, 20(6):62-65.
[20] MacKenzie EJ, Rivara FP, Jurkovich GJ, et al. A national evaluation of the effect of trauma-center care on mortality[J]. N Engl J Med, 2006, 354(4):366-378.
[21] Candefjord S, Asker L, Caragounis EC. Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden:a retrospective study[J]. Eur J Trauma Emerg Surg, 2022, 48(1):525-536.
[22] Holmberg L, Mani K, Thorbj?rnsen K, et al. Trauma triage criteria as predictors of severe injury-a Swedish multicenter cohort study[J]. BMC Emerg Med, 2022, 22(1):40.
[23] Panossian VS, Nederpelt CJ, El Hechi MW, et al. Emergency resuscitative thoracotomy:a nationwide analysis of outcomes and predictors of futility[J]. J Surg Res, 2020,255:486-494.
[24] Holliday A, Samanta D, Budinger J, et al. An outcome analysis of nurse practitioners in acute care trauma services[J]. J Trauma Nurs, 2017, 24(6):365-370.
[25] 陈妮, 邵小平, 韦小梅, 等. 创伤专科护士岗位职责核心指标体系的初步构建[J]. 中华创伤杂志, 2023, 39(2):153-159.
  Chen N, Shao XP, Wei XM, et al. Preliminary construction of a core index system of job responsibilities for specialist trauma nurses[J]. Chin J Trauma, 2023, 39(2):153-159.
[26] 王钰炜, 周帅帅, 王飒, 等. 一站式创伤复苏单元整合5G技术的建设及应用研究[J]. 中华急危重症护理杂志, 2022, 3(4):300-304.
  Wang YW, Zhou SS, Wang S, et al. The construction and practice of a “one-stop” trauma resuscitation unit integrating with 5G technology[J]. Chin J Emerg Crit Care Nurs, 2022, 3(4):300-304.
[27] 武作家, 王飒, 王钰炜, 等. 急诊创伤高级实践护士核心能力评价指标体系的构建研究[J]. 中华急危重症护理杂志, 2022, 3(6):502-507.
  Wu ZJ, Wang S, Wang YW, et al. Construction of evaluation index system of core competence of advanced practice nurses in emergency trauma[J]. Chin J Emerg Crit Care Nurs, 2022, 3(6):502-507.
[28] 王飒, 陈水红, 闫丹萍. 创伤3“T”管理模式在多发伤救治中的应用[J]. 中华急诊医学杂志, 2020, 29(7):999-100.
  Wang S, Chen SH, Yan DP. The application of trauma 3“T” management model in the treatment of multiple injuries[J]. Chin J Emerg Med, 2020, 29(7):999-100.
[29] 王飒, 陈水红. 创伤护士三维一体岗位的设置及实践[J]. 中华急危重症护理杂志, 2020, 1(3):262-265.
  Wang S, Chen SH. The establish and practice of trinity post mode of trauma specialized nurses[J]. Chin J Emerg Crit Care Nurs, 2020, 1(3):262-265.
[30] 陈慧娟, 杜哲, 胡畔, 等. 创伤复苏单元功能分级及配置探讨[J]. 创伤与急诊电子杂志, 2021, 9(1):1-7.
  Chen HJ, Du Z, Hu P, et al. Discussion on functional classification and configuration of trauma resuscitation bay[J]. J Trauma Emerg Electron Version, 2021, 9(1):1-7.
[31] 国家卫生健康委办公厅. 国家卫生健康委办公厅关于印发国家创伤医学中心及国家创伤区域医疗中心设置标准的通知[EB/OL]. (2019-08-27)[2024-11-12]. https://www.gov.cn/zhengce/zhengceku/2019-11/15/content_5452451.htm.
  National Health Commission. Notice of the General Office of the National Health Commission on issuing the standards for the establishment of national trauma medical centers and national trauma regional medical centers[EB/OL]. (2019-08-27)[2024-11-12].https://www.gov.cn/zhengce/zhengceku/2019-11/15/content_5452451.htm.
[32] 党星波, 杜工亮, 马龙洋. 创伤复苏单元的特征及建设要点[J]. 中华创伤杂志, 2021(12):1057-1061.
  Dang XB, Du GL, Ma LY. Characteristics and construction requirements of trauma resuscitation bay in China[J]. Chin J Trauma, 2021(12):1057-1061.
[33] 中国创伤救治联盟. 中国创伤救治联盟创伤中心评估管理办法[Z]. 北京: 中国创伤救治联盟, 2021.
  China Trauma Rescue Treatment Association. China trauma rescue treatment association management measures for trauma center evaluation[Z]. Beijing: China Trauma Rescue Treatment Association, 2021.
文章导航

/