ABSTRACT
Objective To evaluate the efficacy and safety of heated gel mattress(HGM) for prevention of heat loss on preterm infants with hypothermia during the transport systematically and objectively. Methods Systematic searches on PubMed, EMBASE, Cochrane Library, Web of Science CBM,CNKI,Wanfang and VIP were performed for randomized controlled trials or quasi-randomized control trials which explored the effects of HGM on prevention of hypothermia in premature infants relative to conventional alternatives. Studies were screened according to inclusion and exclusion criteria,extracting data and assessing quality. Then, Meta-analysis and trial sequential analysis were performed by using RevMan 5.3 and TSA v0.9 software developed at the Copenhagen Clinical Trials Center in Denmark, independently. Results This systematic review included 10 studies which comprised 7 randomized controlled trials and 3 quasi-randomized control trials, encompassing 773 patients. The results of Meta-analysis showed that in HGM group admission temperature on neonatal intensive care unit (standardized mean difference was 0.63, 95% confidence interval was 0.40-0.87, P=0.00), incidence of hypothermia (relative risk was 0.73, 95% confidence interval was 0.57-0.93, P=0.01) and hyperthermia (relative risk was 1.82, 95% confidence interval was 1.31-2.54, P=0.00) compared with the control group had significantly statistical difference;however, there was no significant difference in admission temperature on EM or TWM group, mortality, sepsis, retinopathy of prematurity, intraventricular hemorrhage III/IV between two groups. TSA confirmed that the pooled results of admission temperature on NICU and hyperthermia were stable and reliable; but the combination of low-temperature incidence and mortality indicators suggested that the sample size was insufficient. Conclusions HGM is an effective rewarming intervention that can improve body temperature of hypothermic preterm infants during transport, reduce the incidence of hypothermia but not decrease the incidence of morbidity and complications. However, it is recommended that clinical monitoring of body temperature should be performed dynamically to decrease the potential risk of high fever and complications. In addition, due to the limitation of quantity and quality of included studies, its cost-effectiveness and far-reaching influence on long-term follow-up outcomes need further evaluation through clinical multicenter, large sample, high-quality research.
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Objective To explore the nursing experience of the safe intra-hospital transport of patients with the severe aspiration of the inhalation injury. Method The nursing measures for the intra-hospital transport of 2 cases of smoke pot inhalation injury caused by extracorporeal membrane oxygenation treatment were taken, including disease risk assessment, preparation for transport, organization of a transport team, effective vital signs monitoring during transport, extracorporeal membrane oxygenation (ECMO) pipeline monitoring and nursing and observation and nursing of complications. Result No emergency was found during the transport of patients and both of them were safely transported. Conclusion Such nursing measures as pre-transport assessment and preparation and bettering predictive nursing for the patients with severe inhalation pulmonary injury treated with extracorporeal membrane oxygenation are key to the safety during intra-hospital transport.
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Objective To explore risk factors of oxygen saturation (SpO2) decrease during intrahospital transporta-tion (IHT) of intensive care unit (ICU) patients in emergency department,and provide theoretical basis for prevent-ing oxygen saturation decrease during intrahospital transportation. Methods A cross-sectional study design was adopted,from April to May,2017,we investigated 182 ICU patients who required IHT in an emergency department in a tertiary hospital in Shanxi Province by using self-designed Evaluation Form of Intrahospital Transportation for ICU Patients in Emergency Room. We divided patients into two groups based on whether their SpO2 decreased or not. Risk factors of SpO2 decrease were identified by univariate and multivariate Logistic regression analysis. Results Among 182 patients,117 had SpO2 decrease,and the rate of SpO2 decrease was 64.3%. Patient's age,MEWS score, disease type,escort personnel,and oxygen supply device were risk factors of SpO2 decrease. Conclusion SpO2 de-crease is the result of combination of multiple risk factors during IHT. We ought to enhance training of escort person-nel,assess patient's condition and SpO2 level accurately and make plan before transportation,choose qualified oxygen supply device to ensure patients can have effective oxygen supply during IHT,which prevent SpO2 decrease during IHT.
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Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.
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Objective To explore the effect of transport procedure adopted on intra-hospital transport of critically ill patients. Methods Three hundred and fifteen critically ill patients(control group)were intra-hospital transported adopting traditional method,while 309 ones(experimental group)adopting transport procedure. The occurrence rate of accidents of both groups and satisfactory rate of nurses in which the patients were admitted.Result The occurrence rate of accidents in experiment group was lower than that in control group and the satisfactory rate of nurses on transport procedure was higher than that on traditional method with statistical difference(P<0.01).Conclusion The application of transport procedure can effectively minimize the risk of critically ill patients during intra-hospital transport and increase satisfactory rate of medical staffs.