重症烧伤患者的陆地远程安全转运
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摘要
目的总结重症烧伤患者自接式陆地远程安全转运的护理措施和要点。方法对我院2011年2月至2012年6月,11例早期重症烧伤患者进行自接式陆地远程(单程≥400km)转运的临床资料及护理要点进行回顾性分析。结果途中有2例(18.2%)患者出现血压下降;5例(45%)患者出现躁动不安;4例(36.4%)患者出现高热(体温>39.0℃);6例(54.5%)患者出现尿量减少,经过全程专科医疗护理后,11例患者均成功转运到我院,顺利入住烧伤监护病房。结论通过做好出诊前的充分准备,转运前病情评估和预处理,与转出医院的交接,对患者及家属的解释工作是确保远程转运的重要条件。转运途中生命体征的监测及病情观察,保持有效的输液通路及呼吸道通畅,实施专科护理,做好记录,是确保远程安全转运的关键。
Objective To summarize the key points of nursing in the long-distance land transport of severely burned patients. Methods The clinical data and nursing measures of long-distance(≥400km) land transport of 11 severely burned patients were retrospectively analyzed from February 2011 to June 2012. Results During the transport,decreased blood pressure occurred in 2 patients(18.2%),dysphoria in 5 patients(45%),hyperpyrexia of over 39℃ in 4 patients(36.4%),and hypourocrinia in 6 patients(54.5%). All the 11 patients arrived at the target hospital safely and were admitted in intensive care burn unit. Conclusion The key points to guarantee the safety of severely burned patients during long-distance transport are full evaluation of patients' condition,active preparation and pretreatment,well-done handover work,full explanation to patients and their family members,intensive monitoring of vital signs and illness condition,maintaining efficacious infusion routes and clear respiratory pathway,skilled professional care and transport records.
Objective To summarize the key points of nursing in the long-distance land transport of severely burned patients. Methods The clinical data and nursing measures of long-distance(≥400km) land transport of 11 severely burned patients were retrospectively analyzed from February 2011 to June 2012. Results During the transport,decreased blood pressure occurred in 2 patients(18.2%),dysphoria in 5 patients(45%),hyperpyrexia of over 39℃ in 4 patients(36.4%),and hypourocrinia in 6 patients(54.5%). All the 11 patients arrived at the target hospital safely and were admitted in intensive care burn unit. Conclusion The key points to guarantee the safety of severely burned patients during long-distance transport are full evaluation of patients' condition,active preparation and pretreatment,well-done handover work,full explanation to patients and their family members,intensive monitoring of vital signs and illness condition,maintaining efficacious infusion routes and clear respiratory pathway,skilled professional care and transport records.
引文
[1]刘云松.陆地远程转运危重病人的经验[J].中国急救医学,2004,24(7):封三.
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[10]杨宗城.烧伤治疗学[M].3版.北京:人民卫生出版社,2006:73,171.
[11]张德河.浅析院前急救医患纠纷的常见隐患及防范对策[J].临床急诊杂志,2009,10(2):118-119.
[12]白素琼,肖佐才.院前急救医护人员职业伤害及防护[J].中外医学研究,2010,8(2):124.
[2]林涵真,危丽华,董馨.急诊危重患者的院内转运体会[J].中国误诊学杂志,2007,17(7):4027.
[3]张卫青,那建华,王福利.建立急救护理流程的实践与思考[J].护士进修杂志,2010,25(17):1558-1559.
[4]陈小群,盛迪,赵雪江.机械通气患者出现人机对抗的护理[J].护理与康复,2005,5:370.
[5]吴冬妹.ICU患者转运中的危险因素及防范措施体会[J].中国误诊学杂志,2010,10(5):1080-1081.
[6]王飞.丙泊酚用于长途转运机械通气患者的镇静治疗二例[J].中国急救复苏与灾难医学杂志,2008,3(1):48-49.
[7]杨宗城,汪仕良,周一平.实用烧伤外科学手册[M].北京:人民军医出版社,2000:60.
[8]吕传柱,周才旺,张玉霞,等.院前急救在急救医学与医疗卫生服务体系中的重要作用[J].中国急救医学,2002,22(6):370.
[9]陈玉明,刘林成,唐剑星,等.院前急救学[M].武汉:湖北科学技术出版社,1999:2-3,379.
[10]杨宗城.烧伤治疗学[M].3版.北京:人民卫生出版社,2006:73,171.
[11]张德河.浅析院前急救医患纠纷的常见隐患及防范对策[J].临床急诊杂志,2009,10(2):118-119.
[12]白素琼,肖佐才.院前急救医护人员职业伤害及防护[J].中外医学研究,2010,8(2):124.