目的分析儿童医疗机构抢救车内急救药品的配备和使用现状,为抢救车内急救药品目录的优化提供参考。
方法通过问卷调查方式,收集我国11省市12家儿童医疗机构抢救车内急救药品目录,对配备的急救药品种类和数量进行对比;采用现场访谈法调研12家医疗机构急救药物使用中存在的问题。通过医院信息系统收集2022年5月至2023年4月山西省儿童医院(我院)普外科和心内科抢救车内急救药品的使用信息,计算其用药频次和单人次用量。对收集的数据进行描述性统计分析。
结果12家儿童医疗机构抢救车内急救药品目录均不相同,药品种数为7~22种,共涉及23种药品,均为注射剂,主要为血管活性药、强心药、抗心律失常药、抗心绞痛及抗心肌缺血药、解痉药、利尿药、脱水药、镇静催眠药、糖皮质激素。12家医疗机构的目录中均包含的药品有肾上腺素、多巴胺、地塞米松、呋塞米、阿托品;有4家医疗机构全院抢救车内所备药品一致,另8家机构各科室根据诊疗需求选备不同的急救药品。12家医疗机构均没有急救药品使用手册。现场访谈发现,抢救车内药品配备和使用中现存问题主要涉及药品种类、配备数量、标签、储存、采购、使用等6个方面。我院普外科和心内科抢救车内急救药品种类和配备基数均相同,抢救时用到的药品分别为6种和9种,在2个科室使用频次均为0的药品包括异丙嗪、利多卡因、地西泮、苯巴比妥、山莨菪碱、碳酸氢钠、阿托品、葡萄糖、葡萄糖酸钙。
结论儿童医疗机构抢救车内急救药品存在配备种类和数量不合理的现象,配备的药品与临床实际需求不完全相符。临床急需适合儿童医疗机构抢救车内药品配备的指南和使用手册,以提高急救药品配备的科学性和使用的正确性。
ObjectiveTo analyze the current preparation and usage situation of first-aid drugs in the rescue vehicles in children's medical institutions, and provide references for optimizing the list of emergency drugs.
MethodsFirst-aid drug lists in the rescue vehicles of 12 children's medical institutions from 11 provinces and municipalities in China were collected through questionnaire surveys, and the drugs as well as their quantities were compared. The existing problems in the use of first-aid drugs in the 12 medical institutions were investigated by on-site interviews. The usage information of first-aid drugs in the rescue vehicles of the General Surgery and Cardiology Department of Shanxi Children's Hospital from May 2022 to April 2023 was collected through the hospital information center, and usage frequency and dosage per patient of the drugs were calculated. Descriptive statistical analysis was conducted on the collected data.
ResultsThe first-aid drug lists in 12 hospitals were various, including 7 to 22 kinds of drugs and involving a total of 23 drugs. These mainly included vasoactive drugs, cardiotonic drugs, antiarrhythmic drugs, antiangina and anti-ischemic drugs for the heart, antispasmodic drugs, diuretics, dehydrating drugs, sedative-hypnotic drugs, and glucocorticoids, all of which were injections. The drugs that were included in all the lists of 12 hospitals were epinephrine, dopamine, dexamethasone, furosemide, and atropine. The drug lists of different rescue vehicles throughout the hospital were the same in 4 hospitals, while the lists varied among departments based on their specific clinical needs in the other 8 hospitals. None of the 12 hospitals had a first-aid drug usage manual. The on-site interview results showed that, the existing problems about drug preparation and use in rescue vehicles mainly involved the following 6 aspects: drug types, quantities, labels, storage, procurement, and usage. In Shanxi Children's Hospital, the types and quantities of first-aid drugs in rescue vehicles of General Surgery Department and Cardiology Department were the same. There were 6 and 9 kinds of drugs were used in the 2 departments during rescue operations, respectively. The drugs that were never used in either department included promethazine, lidocaine, diazepam, phenobarbital, raceanisodamine, sodium bicarbonate, atropine, glucose, and calcium gluconate.
ConclusionsThe phenomenon of unreasonable kinds and quantities of first-aid drugs in the rescue vehicles existed in the children's medical institutions, and the drugs provided did not fully match the actual clinical needs. There was an urgent need for preparation guidelines and usage manuals of first-aid drugs that were suitable for children's medical institutions to enhance the scientificity of drug supply and the correctness of usage.
薛智民,范惠霞,高明娥,等. 儿童医疗机构抢救车内急救药品配备现状调查及应用情况分析[J]. 药物不良反应杂志,2025,27(03):169-175.
DOI:10.3760/cma.j.cn114015-20240428-00283版权归中华医学会所有。
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薛智民:研究设计、资料收集、数据统计、论文撰写;范惠霞:研究设计;高明娥、鲁滔滔:资料收集和复核

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