Gordon M Riha, Alyssa Johnson, Sadie Arnold, Michael S Englehart, Simon J Thompson
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引用次数: 0
摘要
目的:蒙大拿州涵盖并定义了当今美国的农村医疗保健。在这片广袤的土地上,各地的医疗服务设施不尽相同,但获得输血用血液制品的途径却各不相同。此外,及时转运经常受到天气的影响,因为天气可能会限制空中运输的选择,导致地面运输需要多个小时才能到达最终医疗机构:蒙大拿州创伤救护委员会(Montana State Trauma Care Committee,MT-STCC)建立了蒙大拿设施间血液网络(Montana Interfacility Blood Network,MT-IBN),以确保在地理位置偏远的病例中血液的供应,否则患者可能无法存活。本文介绍了促使蒙大拿州医疗机构间血液网络正式发展的病例,并通过第二个病例说明了医疗机构间血液网络的发展过程:本过程与开发手稿详细介绍了 MT-STCC 为开发这一美国农村医疗保健领域独有的新兴理念所做的创新努力。我们回顾了为确定 MT-IBN 的广泛方面而制定的指导方针,包括共享资源的原因、适当包装、转移所需的文书工作以及如何直接向患者提供资源。最后,我们介绍了该州的实施情况:MT-IBN 是由 MT-STCC 研发的,旨在为蒙大拿州通过陆路转运到最终医疗机构的患者提供救生血液,而无需在中间设施停留。这已经在一些因偏远而血液供应有限的地区挽救了生命。
The Montana Interfacility Blood Network: A Novel Lifesaving "Hand-off" for the Optimal Care of Rural Patients.
Purpose: The state of Montana encompasses and defines rural health care as it is known in the United States (US) today. This vast area is punctuated by pockets of health care availability with varying access to blood products for transfusion. Furthermore, timely transport is frequently challenged by weather that may limit air transportation options, resulting in multiple hours in ground transport to definitive care.
Patients and methods: The Montana State Trauma Care Committee (MT-STCC) developed the Montana Interfacility Blood Network (MT-IBN) to ensure blood availability in geographically distanced cases where patients may otherwise not survive. The index case that led to the formal development of the MT-IBN is described, followed by a second case illustrating the IBN process.
Results: This process and development manuscript details the innovative efforts of MT-STCC to develop this fledgling idea unique to rural US health care. We review guidelines that have been developed to define broad aspects of the MT-IBN including the reason to share resources, proper packaging, paperwork necessary for transfer, and how to provide resources directly to the patient. Finally, we describe implementation within the state.
Conclusion: The MT-IBN was developed by MT-STCC to facilitate the hand-off of lifesaving blood to patients being transported by ground to definitive care in Montana without having to stop at an intermediary facility. This has already led to lives saved in areas that are limited in blood availability due to rurality.
期刊介绍:
The Journal of Blood Medicine is an international, peer-reviewed, open access, online journal publishing laboratory, experimental and clinical aspects of all topics pertaining to blood based medicine including but not limited to: Transfusion Medicine (blood components, stem cell transplantation, apheresis, gene based therapeutics), Blood collection, Donor issues, Transmittable diseases, and Blood banking logistics, Immunohematology, Artificial and alternative blood based therapeutics, Hematology including disorders/pathology related to leukocytes/immunology, red cells, platelets and hemostasis, Biotechnology/nanotechnology of blood related medicine, Legal aspects of blood medicine, Historical perspectives. Original research, short reports, reviews, case reports and commentaries are invited.