Prehospital Trauma Compendium: Management of Injured Pregnant Patients- A Position Statement and Resource Document of NAEMSP.

IF 2.1 3区 医学 Q2 EMERGENCY MEDICINE
Lauren M Maloney, Ashley N Huff, Katherine Couturier, Karin A Fox, John W Lyng, Christian Martin-Gill, Rickquel P Tripp, Jenna M B White, Francis X Guyette
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Abstract

The assessment and management of critically injured pregnant trauma patients represents a high-risk, low-frequency event. One in every 12 pregnant patients experience physical trauma during their pregnancy, but only 0.1% experience major trauma with an injury severity score (ISS) greater than fifteen. It is crucial that emergency medical services (EMS) clinicians understand the anatomic and pathophysiologic changes that impact morbidity and mortality for pregnant trauma patients so they can effectively provide life-saving interventions and resuscitation for this patient population.

院前创伤简编:院前创伤简编:受伤孕妇的管理 - NAEMSP 的立场声明和资源文件。
妊娠创伤重症患者的评估和管理是一个高风险、低频率的事件。每12名怀孕患者中就有1人在怀孕期间经历过身体创伤,但只有0.1%的人经历过伤害严重程度评分(ISS)大于15的重大创伤。紧急医疗服务(EMS)临床医生了解影响怀孕创伤患者发病率和死亡率的解剖和病理生理变化是至关重要的,这样他们才能有效地为这一患者群体提供挽救生命的干预和复苏。NAEMSP建议:对于妊娠至少20周的受伤孕妇(或宫底高度在脐水平处),应尽可能进行手动左侧子宫移位。EMS临床医生应该意识到,失血性休克的迹象可能是微妙的或延迟在受伤的孕妇。EMS临床医生应该意识到怀孕患者群体的独特临床特征,需要修改典型的救生干预措施,包括出血控制和复苏、气道和通气管理、张力气胸减压、烧伤和吸入性损伤管理以及疼痛管理。对于至少妊娠20周的受伤妊娠患者的外伤性院外循环停止(TOHCA),在TOHCA的正确原因得到解决后,自发循环没有恢复,如果EMS医生在场,理想情况下应在产妇骤停后4分钟内开始复苏子宫切开术。EMS临床医生应该了解何时需要进行院内复苏子宫切开术,提供清晰和早期的到达前通知,并加快运送到最近的合适医院。当怀孕患者考虑拒绝医疗救助时,EMS临床医生应仔细考虑和讨论即使是看似轻微的创伤也可能发生危及生命的母婴发病和死亡风险。EMS临床医生应该促进关于怀孕特有的伤害预防策略的对话,例如正确使用安全带。EMS临床医生在照顾受伤的孕妇时应考虑亲密伴侣暴力的可能性。
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来源期刊
Prehospital Emergency Care
Prehospital Emergency Care 医学-公共卫生、环境卫生与职业卫生
CiteScore
4.30
自引率
12.50%
发文量
137
审稿时长
1 months
期刊介绍: Prehospital Emergency Care publishes peer-reviewed information relevant to the practice, educational advancement, and investigation of prehospital emergency care, including the following types of articles: Special Contributions - Original Articles - Education and Practice - Preliminary Reports - Case Conferences - Position Papers - Collective Reviews - Editorials - Letters to the Editor - Media Reviews.
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