临床研究
ENGLISH ABSTRACT
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
薛智民
范惠霞
高明娥
鲁滔滔
作者及单位信息
·
DOI: 10.3760/cma.j.cn114015-20240428-00283
Investigation of the current preparation status and analysis of the application on first-aid drugs of rescue vehicles in children′s medical institutions in China
Xue Zhimin
Fan Huixia
Gao Ming′e
Lu Taotao
Authors Info & Affiliations
Xue Zhimin
Department of Pharmacy, Children′s Hospital of Shanxi, Taiyuan 030013, China
Fan Huixia
Department of Pharmacy, Children′s Hospital of Shanxi, Taiyuan 030013, China
Gao Ming′e
Department of Pharmacy, Children′s Hospital of Shanxi, Taiyuan 030013, China
Lu Taotao
Department of Pharmacy, Children′s Hospital of Shanxi, Taiyuan 030013, China
·
DOI: 10.3760/cma.j.cn114015-20240428-00283
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摘要

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。

医院,儿科;急救;急诊处理;目录,药物;抢救车
ABSTRACT

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.

Hospitals, pediatric;First-aid;Emergency treatment;Catalogs, drug;Rescue vehicles
Fan Huixia, Email: mocdef.6ab21aixiuhnaf
引用本文

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

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急救药品在病情危重患者的急救中起着重要作用。为确保急救药品的即时可用,医院通常会配备抢救车,并要求其配置适宜的急救药品和物品。美国用药安全实践研究所《医院用药安全自我评估标准》中推荐,在抢救车中除配备急救药品外,还应配备标准化的且与所配备药品剂量、剂型和浓度一致的急救药品使用指导手册 [ 1 ]。然而,对目前抢救车内的急救药品,我国大多数医院尚无统一的配置标准,这可能会导致药品配置数量或种类欠合理 [ 2 ]。为了提高临床抢救效率,降低急救药品的非必要损耗,同时还要考虑提高护士的操作便利性和工作效率,有必要明确药品的配置种类和数量。李鑫等 [ 3 ]对病区抢救车药品配备方案的优化进行探讨时提出,制定个性化抢救车药品优化配置方案可提高抢救效率和药品管理水平。然而,儿童处于生长发育过程中,各器官系统的功能尚未发育完善,对很多药物的反应与成人有明显差异。目前有关综合医院抢救车内药品配备的研究结果并不能完全适用于儿童医疗机构。
福棠儿童医学发展研究中心由国家民政部批准,成立于2016年,是全国首家从事儿童医学研究的非营利性社会服务组织,现已建立起以全国65家省市级医疗单位为核心,覆盖3 000余家基层医疗机构的儿科分级诊疗网络体系。为了解我国儿童医疗机构抢救车内急救药品配备的现状,福棠儿童医学发展研究中心药学专业委员会组织开展了对儿科分级诊疗网络体系内12家理事成员单位(均为儿童医疗机构)急救药品配备情况的调查。本研究对该调查结果进行报道,并对山西省儿童医院(我院)普外科和心内科抢救车内急救药品的应用情况进行分析。
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备注信息
A
范惠霞,Email: mocdef.6ab21aixiuhnaf
B

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

C
所有作者声明不存在利益冲突
D
感谢福棠儿童医学发展研究中心理事成员单位对本研究的支持及首都医科大学宣武医院药学部张青霞主任药师给予的指导和帮助
E
福棠儿童医学发展中心研究项目 (FTSCR-2022-02)
山西省儿童医院院内项目 (201949)
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