目的 了解目前急诊专科护士专业化发展需求。 方法 采用方便取样的方法，对2012年3月－9月参加四川省急诊专科护士培训的77名学员进行问卷调查。 结果 急诊专科护士专业化发展呈现多元化的需求，主要集中在急危重症患者的抢救与护理、院前急救、物资管理和仪器使用与保养、预检分诊技术、灾害救援与突发事件应对、人才培养、护理科研7个方面。不同层次的急诊专科护士对专业化发展的需求有所差异。 结论 对于不同层次的急诊专科护士采用分层次培训模式及发展急诊亚专业人才是急诊护理末来的发展趋势。
目的 总结大型灾害情况下，急诊伤员信息收集流程，为制定大型灾害救援提供证据支持。 方法 回顾性分析汶川地震（2008年5月12日－6月2日）和玉树地震（2010年4月14日－5月1日）伤员信息收集方法，总结两次地震伤员信息收集管理过程中发现的问题及取得的经验。 结果 通过制作地震伤员登记表、调整病历收集与管理模式、分诊提前、伤员信息登记提前，调整急诊功能分区、头像采集技术的使用、成批伤员信息资料袋和分诊信息卡的应用，最大限度地保证了伤员信息收集的完整性。 结论 地震伤员信息资料的准确性、完整性、及时性在伤员的救治、伤员的查找、伤员的转归和各类医疗信息的收集，以及制定大型灾害事故应急预案等方面起着非常重要的作用。
ObjectiveTo investigate nurses' attitude on the reporting of clinical adverse events and analyze its correlated factors in the Emergency Department. MethodsA total of 130 nurses in a class-3 grade-A hospital were recruited in our study by convenience sampling method during November and December 2014. The Chinese version of Reporting of Clinical Adverse Events Scale was applied to assess nurses' attitude on reporting adverse events. ResultsThe nurses' willingness to report adverse events in the Emergency Department was generally low, and the attitude scores of nurses in the triage zone, rescue zone, monitoring zone and observation zone were respectively 65.62±1.16, 65.49±0.58, 65.06±0.80, and 63.20±0.86, without any significant difference among these zones (P>0.05). The attitude scores of nurses with a seniority of 1-2, 3-5, 6-9, and ≥ 10 years were respectively 67.37±3.27, 64.49±3.98, 63.77±4.82, and 64.30±4.52, with significant differences among these seniority groups (P＜0.05). The attitude scores of nurses with a rank of nurse-in-charge, primary nurse, and nurse were respectively 61.25±4.02, 63.97±4.52, and 65.92±4.02, also with significant differences among these groups (P＜0.05). ConclusionsThe willingness of reporting clinical adverse events in emergency nurses is not high. It is necessary to strengthen the training of nurses on their cognition of adverse events and encourage reporting, thus to create a non-punishment hospital security culture.
ObjectiveTo systematically review the intervention efficacy of resistance exercise on prediabetes and type 2 diabetes. MethodsPubMed, The Cochrane Library, EMbase, Web of Science, EBSCO, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of resistance exercise applied to pre-diabetic and type 2 diabetic population from 2010 to April, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Revman 5.1 and Stata 12.0 software. ResultsA total of 26 RCTs involving 2 078 patients were included. The results of meta-analysis showed that resistance exercise could improve fasting blood glucose (MD=−0.57, 95%CI −0.69 to −0.45, P<0.000 01), glycosylated hemoglobin (MD=−0.28, 95%CI −0.33 to −0.22, P<0.000 01), high density lipoprotein (MD=0.06, 95%CI 0.01 to 0.11, P=0.01), low density lipoprotein (MD=−0.35, 95%CI −0.47 to −0.24 , P<0.000 01), total cholesterol (MD=−0.25, 95%CI −0.39 to −0.12, P=0.000 3), steady-state model-insulin resistance index (MD=−0.74, 95%CI −0.80 to −0.68, P<0.000 01), and body mass index (MD=−0.54, 95%CI −1.03 to −0.05, P=0.03) compared with control group. ConclusionsResistance exercise can improve the blood glucose, blood lipid, and insulin resistance levels of individuals with abnormal glucose and lipid metabolism. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.
Objective To investigate the status quo of knowledge and attitude towards pain among medical staff in West China Hospital of Sichuan University. Methods The medical staff in Emergency Department of West China Hospital of Sichuan University were investigated by the Chinese version of Knowledge and Attitudes Survey Regarding Pain (2008) questionnaire, the contents of which related to pain assessment, pain related knowledge, analgesic related knowledge, and comprehensive application, etc. And the questionnaire scores were compared among medical workers with different background. Results A total of 156 questionnaires were sent out and 130 valid ones were taken back, with an effective recovery rate of 83.3%. There was no statistically significant difference in questionnaire scores among the medical workers with different education background or different professional titles (P>0.05). The questionnaire scores were significantly different among nurses with different seniority (F=3.785, P=0.035), and the mean score of the nurses with more than 10 years of seniority was the highest (22.78±7.11). The questionnaire scores were significantly different among nurses working in different areas (F=3.043, P=0.033), and the mean score of the nurses working in rescue room was the highest (24.53±7.84).The erroneous items were concentrated on item 5, 17, 19. In the answers to the open questions, 97.7% (127/130) thought that the existing pain knowledge could not satisfy the needs of clinical work; 100.0% (130/130) believed that it was necessary to study pain related knowledge; 80.0% (104/130) acquired pain related knowledge from clinical experience, 40.0% (52/130) from books, 15.4% (20/130) from the network; 90% ( 117/130) commonly used numeric rating scale to evaluate the patients’ pain degree, 20.0% (26/130) evaluated the patients’ pain degree through facial expressions. Conclusions The overall level of pain management knowledge and attitude in medical staff in Emergency Department is low. The continuing education on pain knowledge should be strengthened, the attitude towards pain treatment and the importance of pain management should be paid more attention, and the standardized training and supervision should be enhanced.
ObjectiveThis study aimed to systematically review the quality of psychometric properties and methodological quality of the Chinese versions of fear of falling assessment tools for the elderly, providing evidence-based guidance for medical staff in selecting high-quality assessment tools. MethodsWe systematically searched CNKI, WanFang Data, VIP, CBM, PubMed, Embase, and Web of Science databases for studies related to the evaluation of psychometric properties and methodological quality of fear of falling assessment tools for the elderly. The search spanned from the inception of the databases to January 19, 2024. Two researchers independently screened literature and extracted data using the consensus-based standards for the selection of health measurement instruments. The COSMIN risk of bias checklist and quality criteria were employed to evaluate instrument measurement characteristics and formulate final recommendations. ResultsFifteen studies involving 11 Chinese versions of fear of falling assessment tools for the elderly were included. None of the studies reported measurement error, cross-cultural validity, or responsiveness. Due to insufficient or uncertain content validity and low or below-quality evidence, all 11 tools received a recommendation of level B. ConclusionAmong the 11 instruments, the Chinese version of IFES demonstrates the most balanced measurement characteristics, along with good reliability and validity. However, further verification of other measurement characteristics of this instrument is warranted.
Acute compartment syndrome (ACS) is one of the serious complications of snake bites, which can lead to amputation or even death in severe cases. Early diagnosis and treatment of ACS remain a major challenge. This paper focuses on the latest research trends in early diagnosis of ACS, with an emphasis on the application of emerging monitoring technologies in critical areas such as intercompartmental pressure measurement, oxygenation monitoring, and perfusion monitoring. It also provides a comprehensive analysis of diverse treatment strategies including surgical and conservative interventions, aiming to offer more precise diagnostic and treatment guidelines for clinical practitioners.
Objective To investigate the efficacy on clinical condition assessment and the safety of ultrasound-guided osteofascial chamber puncture manometry in evaluating the pressure of the osteofascial chamber in patients with venomous snake bites. Methods Patients with venomous snake bites admitted to the Department of Emergency Medicine of West China Hospital of Sichuan University between April 2021 and January 2023 were prospectively included, and their basic information, physiological indicators (heart rate, blood pressure), laboratory examination indicators, physical signs, treatment methods and prognosis were collected. The patients whose extremal pressure was measured by osteofascial chamber puncture under ultrasound guidance were selected as the manometry group. Patients who were bitten by venomous snakes at the same time without puncture pressure measurement were randomly selected as the control group at a ratio of 1∶1. The bleeding, infection, nerve injury, length of hospital stay and long-term prognosis of the two groups were compared to explore the safety of ultrasound-guided osteofascial chamber puncture manometry. The correlation between the pressure measured in the manometry group and creatine kinase (a representative index of acute poisoning severity score) was analyzed to explore the efficacy of ultrasound-guided osteofascial chamber puncture manometry in evaluating the disease. Results There was no significant difference between the manometry group and the control group in new or aggravated infection, bleeding, nerve injury (such as numbness and anesthesia), hospital treatment time, final detumescence time of the affected limb, or final adverse prognosis (P>0.05). There was a positive correlation between the measured pressure and creatine kinase (rs=0.286, P=0.002). Conclusions The higher pressure measured by ultrasound-guided osteofascial chamber puncture manometry is, the more serious the poisoning condition may be. In addition, ultrasound-guided osteofascial chamber puncture manometry does not prolong the hospital time of patients or the final swelling reduction time of the affected limb, and does not increase the incidence of bleeding, infection, nerve damage or eventual adverse prognosis events. It has clinical practicability and feasibility.