急诊血管通路项目对静脉注射困难患者的卫生系统影响。

POCUS journal Pub Date : 2025-04-15 eCollection Date: 2025-04-01 DOI:10.24908/pocusj.v10i01.18274
Nathan P Roll, Shilpa Raju, Micah Ownbey, Jamal Jones, Christy Hopkins, Jennifer Cotton
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引用次数: 0

摘要

背景:超声引导(USG)外周静脉(PIV)通道是护理点超声(POCUS)的重要应用,它减少了进入时间,减少了对更多侵入性通道的需求,保留了血管系统,改善了患者体验。目的:我们描述了急诊部(ED)基于血管通路计划的影响,该计划由专业的护理人员和紧急医疗技术人员(emt)组成。该团队接受过USG PIV访问方面的培训,以帮助在急诊科和整个学术医疗中心有静脉注射困难(DIVA)的患者。方法:本描述性报告详细介绍了在单一学术中心接受USG PIV安置培训的高技能血管通路团队的实施、发展和演变。在超声研究员培训的指导下,委员会认证的急诊医学(EM)超声教师,ED护理人员和emt提供全面的培训和监督USG PIV安置。描述了程序描述、患者选择和账单捕获。该报告符合机构审查委员会作为描述性质量改进项目的豁免标准。结论:本报告详细介绍了一支高技能血管通路团队的组建和维护。该团队由接受过USG PIV安置培训的护理人员和急救人员组成,使他们能够照顾DIVA患者。该团队的发展使得血管通路和血管保存的分层方法在整个组织中得以发展,使患者和医院工作人员都受益。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Health System Impact of Emergency Department-Based Vascular Access Program in Patients with Difficult Intravenous Access.

Background: Ultrasound guided (USG) peripheral intravenous (PIV) access is a vital use of point of care ultrasound (POCUS) that decreases time to access, reduces need for more invasive access, preserves vasculature, and improves patient experience.

Objectives: We describe the impact of an Emergency Department (ED) based vascular access program with a specialized team of paramedics and emergency medical technicians (EMTs). This team is trained in USG PIV access to assist with patients that have difficult intravenous access (DIVA) both in the ED and throughout the academic medical center.

Methods: This descriptive report details the implementation, development, and evolution of a highly skilled vascular access team trained in USG PIV placement at a single academic center. Under the guidance of ultrasound fellowship trained, board-certified Emergency Medicine (EM) ultrasound faculty, ED paramedics and EMTs are provided comprehensive training and oversight of USG PIV placement. Program description, patient selection, and billing capture are described. This report met Institutional Review Board exemption criteria as a descriptive quality improvement project.

Conclusions: This report details the formation and maintenance of a highly skilled vascular access team. The team is comprised of paramedics and EMTs who have been trained in USG PIV placement allowing them to care for patients with DIVA. The evolution of this team has allowed the development of a tiered approach to vascular access and vascular preservation throughout the organization, benefitting both patients and hospital staff.

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