兒童創(chuàng)傷急救-免費(fèi)閱讀
【正文】 如 1歲 , 15次 /分鐘。 Campbell,International Trauma Life Support, 6th Ed. 169。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ LifeThreatening Injuries 危害生命傷勢(shì) Head injury頭部受傷 ? Most mon cause of death最常見死亡原因 ? Level of consciousness change best indicator 清醒程度之改變?yōu)樽钣行У恼鳡? ? Pupil assessment important檢查瞳孔 25 Trauma in Children 第二十五頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Shock in Children Strong pensatory mechanisms生理的補(bǔ)嘗機(jī)制較強(qiáng) Appear surprisingly good in early shock 早期休克可有效發(fā)揮 “Crash〞 when deteriorate但情況會(huì)急轉(zhuǎn)直下 Be prepared必需有心理準(zhǔn)備 Fluid administration 20 mL/kg in each bolus輸液補(bǔ)充每次 20 mL/kg Consider intraosseous infusion骨髓輸液法 Frequent Ongoing Exams持續(xù)檢查 21 Trauma in Children 第二十一頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ Airway in Children Opening airway張開氣道 ? Tongue is large。 2024 Pearson Education, Inc., Upper Saddle River, NJ Pediatric Equipment兒科器材 Lengthbased tape身長(zhǎng)尺 ? Weight estimate大約體重 ? Fluid and medication doses precalculated 輸液及藥物劑量 ? Common equipment size estimates 常用器材尺碼 10 Trauma in Children Photo courtesy of Kyee Han, MD 第十頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Assessing Mental Status 撿查精神狀態(tài) Consoled or distracted可按撫或轉(zhuǎn)注意力 ? Most sensitive indicator of adequate perfusion 能準(zhǔn)確反映組織灌注是否足夠 ? Caregivers best at detecting subtle changes 照顧者會(huì)較易分辯出傷者微小改變 6 Trauma in Children 第六頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Trauma in Children Trauma in Children 兒童創(chuàng)傷 第二頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 Campbell,International Trauma Life Support, 6th Ed. 169。 Campbell,International Trauma Life Support, 6th Ed. 169。 tissue soft舌大 ,組織軟 ? Jawthrust下頷上提法 ? Oropharyngeal airway口咽氣道 ? Nasopharyngeal airways鼻咽氣道 – Too small to work predictably 因鼻孔太少未必有效 ? Neonate obligate nose breather 新生嬰兒用鼻孔呼吸 ? Clear nose with bulb syringe用球狀泵吸走分泌 14 Trauma in Children 第十四頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Endotracheal Intubation 氣管內(nèi)導(dǎo)管 Oral endotracheal intubation從口腔插入 ? No blind nasotracheal intubation for 8 years 少于 8歲不可施行鼻入插喉法 Uncuffed tube無氣袋式喉管 – Lengthbased tape system身長(zhǎng)尺 – Same diameter as tip of child’s little finger與小童尾指頭直徑相同 – Frequently reassess placement需經(jīng)常撿查喉管位置 18 Trauma in Children 4 + age in years = size of tube (mm) 4 第十八頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ LifeThreatening Injuries Spinal injury脊椎創(chuàng)傷 ? U
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