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首页> 外文期刊>Emergency medicine journal: EMJ >Use of prothrombin complex concentrates: 4-Year experience of a national aeromedical retrieval service servicing remote and rural areas
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Use of prothrombin complex concentrates: 4-Year experience of a national aeromedical retrieval service servicing remote and rural areas

机译：凝血酶原复合物浓缩物的使用：为偏远和农村地区提供服务的国家航空医学检索服务的4年经验

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Introduction: Prothrombin complex concentrates (PCCs) are recommended as first-line treatment for acquired or congenital factor II, VII, IX and X deficiencies in situations of major haemorrhage. The Emergency Medical Retrieval Service (EMRS) provides critical care and aeromedical retrieval to patients in remote and rural Scotland. It has an important role in the care of these patients. Method: We sought to determine the incidence of haemorrhage requiring PCC administration in our cohort of patients, and to assess compliance with current national guidelines regarding their storage and use. We searched our database for all patients that received PCCs, or met current guidelines for their administration, and followed them through to hospital discharge. We also conducted a telephone survey of all hospitals served by the EMRS to determine compliance with national standards. Results: During the 42-month study period, 1170 retrieval missions were conducted. Twenty-six retrieved patients had a congenital or acquired clotting factor deficiency and seven met criteria for PCC administration. Of these, only three received PCCs prior to transfer to definitive care. Telephone survey revealed that all the rural general hospitals were served by the EMRS stock PCCs, but only one out of 15 GP-led community hospitals had access to PCCs. Conclusions: In the remote and rural setting where access to definitive care may be limited or delayed, timely administration of PCCs in appropriate patients may improve outcomes. As many rural hospitals do not have access to PCCs, the ability of the EMRS to provide this treatment may improve patient care.
机译：简介：凝血酶原复合物浓缩物（PCCs）被推荐作为严重出血情况下获得性或先天性因子II，VII，IX和X缺乏症的一线治疗。紧急医疗检索服务（EMRS）为苏格兰偏远和农村的患者提供重症监护和航空医学检索。它在这些患者的护理中具有重要作用。方法：我们试图确定我们的患者队列中需要PCC给药的出血发生率，并评估对当前国家有关其储存和使用指南的遵守情况。我们在数据库中搜索了所有接受PCC的患者，或符合当前管理指南的患者，并按照他们的指示进行出院。我们还对EMRS服务的所有医院进行了电话调查，以确定是否符合国家标准。结果：在为期42个月的研究期内，进行了1170次检索任务。 26例康复患者患有先天性或获得性凝血因子缺乏症，其中7例符合PCC给药标准。在这些患者中，只有3个在转移到最终护理之前接受过PCC。电话调查显示，所有农村综合医院均由EMRS的PCC提供服务，但是15家由GP领导的社区医院中只有1家可以使用PCC。结论：在偏远和乡村地区，最终医疗的获得可能受到限制或延迟，在适当的患者中及时施用PCC可能会改善结局。由于许多乡村医院无法使用PCC，因此EMRS提供这种治疗的能力可能会改善患者护理。

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