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加强急诊综合管理 提高急诊救护质量

【摘要】 目的 探讨急诊护理的综合管理,提高急诊护士整体素质,全面提升急诊护理质量。方法 规范管理,设计操作流程图,规范护士的行为;加强培训考核力度,使护士熟练掌握急救技能,制定急救护理考核标准,并在急救护理管理中实施全面考核,提高急救护理管理质量。结果 通过实施急诊急救护理的全面考核,规范了急救护理的管理,护理质量明显提高。结论 加强急诊综合管理,提高急诊护理质量,提高患者满意度,树立医院良好形象。

Experience on Treatment of Great Vascular Injury of Trunk and Extremity

目的　总结躯干及肢体大血管损伤救治的经验体会。 方法　对37例躯干及四肢大血管损伤病例资料进行回顾性分析，总结其院前急救、手术方法和围手术期处理经验。结果　全组病例中除2例因失血性休克死亡外，其余病例均痊愈，无血管损伤术后并发症。结论　加强基层医院医生在躯干及四肢大血管创伤救治技术上的培训并得以提高，有利于降低大血管损伤的死亡率和致残率。

Effect of Regional Pediatric Transport Network on Transport and Treatment for Children in Sichuan Province

ObjectiveTo investigate the effect of pediatric medical transport network on transport and treatment for children in Sichuan province. MethodA total of 4647 pediatric patients transported to West China Second University Hospital were recruited from January 2011 and December 2013 in our study, among whom 1 948 were admitted before the establishment of the transport network (January 2011 to August 2012) and 2 699 were admitted after the establishment of the transport network (September 2012 to December 2013). Transport modes, patient disposition and fatality were analyzed to evaluate the role of transport network in the transport and treatment for pediatric patients. ResultsThe transported patients increased significantly after the establishment of transport network (an average of 97 cases increased to 169 cases per month). After transport network was established, valid communication and telephone contact also increased significantly (the proportion increased from 20.64% to 45.28%, P<0.001). There were significant differences in the composition of patients' destination after the establishment of the transport network (P<0.001). After the establishment of transport network, the patients' hospitalized rate and admission rate increased dramatically (from 17.86% to 37.53%, 12.11% to 41.13%, respectively). The fatality decreased from 6.83% to 3.04% (P<0.001). ConclusionsRegional pediatric transport network will contribute to the treatment of pediatric patients within the region, and decrease fatality.

对地震挤压伤患者院前急救的反思与研讨

目的:为挤压伤者的院前急救进行反思和研讨,提出一些新建议,以提高这类伤员的抢救成功率。材料和方法:本文特利用循证医学技术和方法,通过病例分析和文献回顾总结的方式。结果:通过文献回顾和病例分析,地震中挤压伤的院前处理应该注意以下几点:首先是重视早期补液的重要性,特别是液体的类型、量和补碱利尿时机;其次是局部患肢结扎,肢体处理和情绪的稳定;最后伤者获救后切忌盲目转运,现场分拣和急救后再转运。结论:应重视地震伤员院前急救过程中的规范化处理,以期最终改善预后,减少急性肾功衰和脓毒血症的发生,降低病残率和死亡率。

Interpretation of the updated 2019 Wilderness Medical Society Clinical Practice Guidelines for the Treatment and Prevention of Drowning

As a global accidental injury, drowning has a huge spiritual and economic impact on patients, families and society. In order to improve the quality of pre-hospital and in-hospital emergency treatment of drowning, improve the prognosis, improve survival rate, and reduce the burden of drowning, in 2016, the Wilderness Medical Society drafted practice guidelines related to drowning. The first update of this guide was released in June 2019. The updated guide covers the terms of drowning, rescue and resuscitation, emergency treatment, preventive measures and other aspects. This article interprets the updated guidelines in order to provide recommendations for the first aid of drowning.

急救护理记录单的设计与应用效果

【摘要】 目的 改进原来的抢救记录单,减轻急诊护士书写压力,节省时间,规范医疗护理文书,保证病案的完整性,可应对举证责任倒置,且便于统计。方法 回顾检查2009年1月—6月的1 302份抢救记录单,针对其中出现的较普遍问题,如错记、漏记重要病情资料,记录不及时、完整,不规范用语,新记录单书面不整洁等进行分析,并听取护士反映后设计出以选择式、填空式方式结合传统叙述式描述方式的记录单。结果 通过对使用后的新记录单的检查,对比原来的记录单,新记录单书面更整洁、规范,漏记重要异常体征情况明显减少,记录病情、处理措施更及时准确。结论 此记录单可促进护理文书的规范化,方便使用,减轻护士书写压力,有利于提高急救护理质量。

疑似气性坏疽合并感染性休克、急性呼吸窘迫综合征急救护理一例

地震灾害中掩埋140小时伤员的救治体会

地震掩埋往往使伤员丧失食物及水盐来源，引起机体代偿性的能量及水盐代谢变化，严重时，引起伤员器官功能损伤及内环境紊乱，导致生命危险。合理地进行能量补充及水盐紊乱的纠正，预防感染，是救治成功的关键。

腹主动脉瘤破裂患者的急救及护理对策

【摘要】 目的 总结对腹主动脉瘤破裂患者的急救措施及护理对策。 方法 回顾分析2004年1月-2008年2月收治的11例腹主动脉瘤破裂患者抢救及护理过程。 结果 6例患者治愈出院，5例死亡，其中术中失血性休克死亡1例，术后消化道大出血及多功能器官衰竭死亡2例，放弃治疗出院后死亡2例，存活率为54.5%。 结论 通过对腹主动脉瘤破裂患者采取及时有效的抢救配合及护理措施，有效地提高了手术的成功率及生存率。

Satisfaction of Patients and Medical Staff’s Satisfaction with Venous Indwelling Needle the Catheter in Pre-hospital Emergencies

目的　调查在院前急救中医患双方对留置针使用的满意度，并就留置针在急救中应用的合理性进行研究。 方法　将我院急诊科2011年6月－8月院前急救的患者，按出诊顺序分为两组，观察组患者使用留置针穿刺建立静脉通道，对照组则采用一次性静脉输液针，并调查患者或亲属、穿刺操作护士就两种穿刺方法的满意度。 结果　观察组留置针一次穿刺成功者达198例（94.29%），对照组一次穿刺成功者为206例（88.79%），两组比较差异有统计学意义（P＜0.05）；护士对留置针使用满意度明显高于一次性静脉输液针；患者及家属对留置针在保持静脉通道通畅、输液肢体舒适的满意度较一次性静脉输液针高。 结论　静脉留置针在院前急救中能提高医患双方的满意度，值得推广使用。