危重型新型冠状病毒肺炎患者医院之间转运流程及临床应用12例分析  

Analysis of transport process and clinical application of 12 cases of se-vere COVID19 patients

作　　者：张国明 余裕恒 黄煌 范银强 刘昶权 曹皇亮 潘越峻 陈凤娟[3] 雷春亮 何为群[4] 李时悦[4] 邓西龙 ZHANG Guoming;YU Yuheng;HUANG Huang;FAN Yinqiang;LIU Changquan;CAO Huangliang;PAN Yuejun;CHEN Fengjuan;LEI Chunliang;HE Weiqun;LI Shiyue;DENG Xilong(Emergency Medicine Department,Guangzhou Eighth People's Hospital,Guangzhou Medical University,Guangzhou Guangdong 510440,China)

机构地区：[1]广州医科大学附属第八医院急诊医学科,广东广州510440 [2]广州医科大学附属第八医院重症医学科,广东广州510440 [3]广州医科大学附属第八医院传染科,广东广州510440 [4]广州医科大学附属第一医院呼吸与危重症医学科广州呼吸健康研究院国家临床医学研究中心,广东广州510120

出　　处：《中国急救复苏与灾害医学杂志》2021年第8期857-861,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：广东省防治新冠病毒科技攻关专项“新型冠状病毒2019-nCOV重症肺炎临床救治关键技术研究”(编号:2020B111105001)。

摘　　要：目的根据国家卫健委及相关专业指引、结合医院实际情况制定危重型新型冠状病毒肺炎(COVID-19)患者的转运流程,分析临床应用该流程进行院际转运的安全性、有效性及注意事项。方法建立危重型COVID-19患者医院之间转运流程,应用该流程分析12例危重型COVID-19患者院际转运情况,包括转运设备,转运前后患者生命体征(血压、心率、氧合指数)的变化,并发症及处理意外事件;观察参与转运人员14 d内体温、呼吸道症状以及病毒核酸检测情况。结果12例患者[男10例,女2例,平均年龄(59.6±11.8)岁]均成功院际转运。1例患者出现血压下降,发现为输液管道松脱,及时处理后恢复继续转运;1例患者转运过程中出现血氧下降,检查后为呼吸机故障,遂返回医院,第2天更换呼吸机后顺利转运。转运人员无发生交叉感染。结论该流程符合防控要求、实用、可操作性强,可流畅、有效、安全地对危重型COVID-19患者进行医院之间的转运。Objective To establish the transport process of patients with severe COVID-19 according to the guidelines of Health Protection Committee and relevant professional guidelines,and combine with the actual situation of hospitals,and analyze the safety,effectiveness and matters needing attention in the clinical application of the process for inter hospital transshipment.Methods A hospital to hospital transport process for severe COVID-19 patients was estab⁃lished.The process was used to analyze the inter hospital transport of 12 severe COVID-19 patients,including trans⁃port equipment,changes of vital signs(blood pressure,heart rate,oxygenation index)before and after transport,compli⁃cations and treatment of accidents;The body temperature,respiratory symptoms and virus nucleic acid detection of the personnel involved in the transport were observed within 14 days.Results 12 patients(10 males and 2 females,aver⁃age age 59.6±11.8 years)were successfully transported between hospitals.One patient had a drop in blood pressure,which was found to be the loosening of the infusion pipeline,which was treated in time and resumed transportation;One patient had a decrease in blood oxygen during transportation because of ventilator failure.After changing the ventilator the next day,the patient was transported smoothly.There was no cross infection among transporters.Conclusion The process meets the prevention and control requirements,is practical and operable,and can smoothly,effectively and safely transfer between hospitals for severe COVID-19 patients.

关 键 词：新型冠状病毒肺炎 危重型 流程 转运 

分 类 号：R605.97[医药卫生—急诊医学]