兒童創(chuàng)傷急救(完整版)
【正文】 者 – Keep caregivers in physical and verbal Demonstrate petence and passion. 5 Trauma in Children 第五頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Chapter 17 Trauma in Children 第一頁，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。 2024 Pearson Education, Inc., Upper Saddle River, NJ Breathing in Children兒童呼吸 Work of breathing呼吸方法 ? Retractions, flaring, grunting 肋間收縮、 鼻翼擴張、咕嚕聲 ? Persistent grunting requires ventilatio n持續(xù)助呼吸 Respiratory rate呼吸次數(shù) ? Fast, then periods of apnea or very slow 先后短暫停止或轉(zhuǎn)慢 Minor blunt neck trauma can be critical. 輕微頭部挫傷可引起嚴重傷勢 15 Trauma in Children 第十五頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Circulation in Children兒童血循環(huán) 19 Persistent tachycardia is most reliable indicator of shock. 最有效顯示傷者休克的征狀為持續(xù)的脈搏過快 Trauma in Children 第十九頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 older child: 90 mmHg ? 幼兒 : 80 mmHg,小童 : 90 mmHg ? Be prepared to prevent aspiration ? 預防氣道吸入異物 26 Trauma in Children 第二十六頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ LifeThreatening Injuries ? SMR脊椎固定 ? Pad under torsofor neutral position 于天然屈曲位下放置較墊 ? May have to secure without cervical collar 可不使用頸圈固定頸椎 ? Do not restrict chest movement 切勿緊束胸部 30 Trauma in Children 第三十頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ Discussion 34 Trauma in Children 第三十四頁，共三十五頁。 33 第三十五頁，共三十五頁。 Avoid “no〞 questions防止說〞不〞。 2024 Pearson Education, Inc., Upper Saddle River, NJ Child Restraint Seats兒童汽車平安椅 31 Trauma in Children Child in car seat Serious injury嚴重受傷 Remove from car seat 移離平安椅 Apply SMR脊椎固定 No apparent injury無明顯嚴重受傷 Secure and transport in car seat穩(wěn)固后原椅運走 第三十一頁，共三十五頁。 2024 Pearson Education, Inc., Upper Saddle River, NJ LifeThreatening Injuries Chest injury胸部創(chuàng)傷 ? Respiratory distress mon最常見的征狀為呼吸困難 ? Pneumothorax or tension pneumothorax氣胸或張力性氣胸 ? Difficult to assess較難分別 ? Needle thoracostomy can be lifesaving剌胸膜腔穿刺 ? Pulmonary contusion胸部挫傷 ? Rare injuries較少發(fā)生傷勢 ? Rib fractures, flail chest, aortic rupture, pericardial tamponade 肋骨折 、 槤架胸、主動脈撕裂、心胞膜填塞 27 Trauma in Children 第二十七頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ Circulation in Children Early shock more difficult to determine. 較難于休克初期預測 ? Persistent tachycardia持續(xù)的脈搏過快 ? Rate 130 usually shock in all ages except neonates脈搏 130多為休克 ,新生嬰兒除外 – Prolonged capillary refill and cool extremities冷 – Level of consciousness清醒程度 ? Circulation can be poor even if child
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