嚴(yán)重創(chuàng)傷病人的麻醉(已修改)
2025-01-16 02:42 本頁(yè)面
【正文】 嚴(yán)重創(chuàng)傷病人的麻醉 Anesthesia for Trauma ? In advanced countries, injury ranks as the fourth leading cause of death following heart disease, cancer, and cerebrovascular disease. Preoperative Assessment For trauma patients, in addition to the ordinary preanesthetic evaluation, the severity of the trauma should be evaluated. The monly used scoring system including: 1. ASA physical status score It is not very useful for discriminating small difference in severely injured patients. 2. Glasgow a score scale（ GCS） Indicators: Eye opening Spontaneous 4 To voice 3 To pain 2 None 1 Verbal response Oriented 5 Confused 4 Inappropriate words 4 Inprehensible words 2 None 1 Motor responses Obeys Command 6 Localizes pain 5 Withdraws（ pain） 4 Flexion（ pain） 3 Extension（ pain） 2 None 1 Numeric range： 3～ 15 Lower score more serious a 3. Revised Trauma Score（ RTS） Indicators： Systolic blood pressure ≥89mmHg 4 76～ 89mmHg 3 50～ 75mmHg 2 1～ 49mmHg 1 No pulse 0 Weight Respiratory rate 10～ 29/min 4 ＞ 29/min 3 6～ 9/min 2 1～ 5/min 1 None 0 Weight Glasgow Coma Scale 13～ 15 4 9～ 12 3 6～ 8 2 4～ 5 1 3 0 Weight Numeric range 0～ SBP wgt+RR wgt+GCS wgt=TS Lower Score more serious injury 4. Others Refer to the text. Mechanisms of Injury The mechanism of injury determines the pattern of injury, and the knowledge focuses the treatment priorities for the patient. For example: Perating thoracic trauma Blunt Chest trauma The therapeutic approach is quite different. Blunt trauma results in widespread energy transfer to the body. When the limits of lord tolerance are exceeded, Tissues are disrupted depending on the amount of energy transfer. Perating trauma injures as the energy behind the perating instrument causes stretching and crushing of tissues. The energy dissipation profiles of different weapons（ Knives and bullets determine the anatomic de
教學(xué)課件相關(guān)推薦
鄂ICP備17016276號(hào)-1