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[MEDSCAPE新闻]:英国批准使用全身性感染早期预警评分
2018年01月02日 时讯速递, 进展交流 暂无评论

Sepsis Early Warning Score Adopted in UK

Peter Russell

December 20, 2017

Every NHS hospital trust in England will be asked to adopt a new clinical system for assessing acutely ill patients.

英格兰每所NHS医院都将被要求采用一种新的临床系统评估急性病患者。

Almost 2,000 deaths each year could be prevented if consistent checks are made, according to the NHS.

根据NHS报告,如果系统采用这一评分,每年能够避免将近2000名患者的死亡。

The National Early Warning Score (NEWS), developed by the Royal College of Physicians (RCP) in 2012, has now been formally endorsed by NHS England.

国家早期预警评分(NEWS)由皇家内科医生学院(RCP)于2012年建立,目前已经得到英格兰NHS的正式批准。

It is set to become the early warning system for identifying patients who are becoming seriously ill, including those with sepsis.

NEWS将成为鉴别包括全身性感染在内的危重病高危患者的早期预警系统

Sepsis 全身性感染

Sepsis is a serious complication of infection. It occurs when the body's immune system response to infection results in damage to the body's own tissues and organs.

全身性感染是感染的一种严重并发症。当感染引起的机体免疫系统反应导致机体自身组织和器官损伤时,即发生全身性感染。

Sepsis can lead to shock and organ failure if not recognised in its early stages and treated promptly.

如果在疾病早期没有得到及时认识和治疗,全身性感染能够导致休克和器官功能衰竭。

There are around 123,000 cases of sepsis in England each year.

每年英格兰有大约123000例全身性感染患者。

Early Warning System 早期预警系统

The new standardised approach would mean that NHS hospital staff use a scored assessment of a how ill a patient is becoming.

新的标准化做法意味着NHS医院的医务人员将采用评分系统评估一名患者的疾病严重程度。

The score is designed to help healthcare professionals determine whether or not a patient is deteriorating and may need extra care. These key measures are:

设计这一评分系统旨在帮助医务人员确定患者是否会出现病情恶化而需要额外照护。主要指标包括

  • Breathing rate 呼吸频率
  • Pulse rate 脉搏
  • Blood pressure 血压
  • Temperature 体温
  • Level of consciousness 意识水平
  • Oxygen saturation 氧饱和度

A low score would prompt an assessment by a registered nurse, whereas a high score would lead to an emergency assessment by a critical care team and the likelihood of specialist care.

评分较低的患者应当立即由注册护士进行评估,而评分较高的患者应当由重症医学团队对专科治疗的必要性进行紧急评估。

The system has been adopted by the US Navy as well as health authorities in Europe and India. It is estimated that the NEWS is now being used in over 70% of NHS hospitals. However, NHS England wants to see the system also in place for emergency and ambulance care by 2019.

这一系统已经被美国海军及欧洲和印度卫生部门采用。预计目前超过70%的NHS医院正在使用NEWS。然而,英格兰NHS希望在2019年这一系统能够在急诊及急救车中得到使用。

Saving Lives 挽救生命

The quality standard builds on a set of NICE recommendations. These state that health professionals should look for specific symptoms if they think someone has sepsis.

依据一系列NICE的推荐意见制定了质量标准。这些标准要求医务人员怀疑患者罹患全身性感染时,应当寻找特异性临床表现。

Changes to sepsis treatment were promised after a report from the National Confidential Enquiry into Patient Outcome and Death found delays in identifying sepsis in 36% of cases.

National Confidential Enquiry into Patient Outcome and Death出具的报告发现,约36%的全身性感染病例存在诊断延误。因此,卫生部门承诺要改变全身性感染的治疗。

Professor Bryan Williams, chairman of the NEWS Development Group and RCP clinical lead for NEWS, says in a statement: "We developed the NEWS to save lives in the NHS.

Bryan Williams教授是NEWS开发小组主席及RCP有关NEWS临床负责人。他在声明中指出:“我们建立了NEWS以挽救NHS系统中患者的生命。

"The uptake and impact of the NEWS over the past 5 years has been extraordinary, and beyond even the most optimistic expectations, especially considering that there was no national incentive or directive to implement it.

“在过去5年中,NEWS得到了广泛使用,其影响非常显著,远超之前最为乐观的估计,特别是考虑到这些成绩是在没有全国范围内实施计划的前提下实现的。

"The majority of NHS hospitals are now using the NEWS, and over 150,000 NHS staff have voluntarily completed the online NEWS training and accreditation programme."

“大多数NHS医院已经采用了NEWS,超过150000名NHS员工自愿完成了在线的NEWS培训及认证项目。”

Sir Bruce Keogh, NHS England's medical director, says in a statement: "Air Traffic Control systems around the world use common standards and language to prevent disasters and the NHS, with the safety of millions of patients every year at stake, should be no different."

英格兰NHS医学总监Bruce Keogh爵士在声明中提到:“全球航空运输控制系统采用了相同的标准及语言以预防灾难发生,NHS以成千上万的患者安全为己任,其做法不能有所不同。”

Dr Ron Daniels, chief executive of the UK Sepsis Trust, comments in an emailed statement: "This is a major step forward and the national roll out of the score has the potential to save thousands of lives.

Ron Daniels医生是英国全身性感染协会的首席执行官。他在电子邮件中写到:“这是一个很大的进步,全国范围内采用这一评分可能挽救成百上千名患者的生命。

“在NHS系统内,医务人员能够使用相同的工具诊断并治疗全身性感染,这一点非常重要。”

"It's vital that healthcare professionals have access to tools for diagnosing and treating sepsis that are consistent across the NHS."

SOURCES:

The Royal College of Physicians (RCP)

NHS England 

UK Sepsis Trust

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