兒童創(chuàng)傷急救(編輯修改稿)
2024-10-01 16:40 本頁面
【文章內(nèi)容簡介】 ctably 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。 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(kuò)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(yán)重傷勢 15 Trauma in Children 第十五頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ 20, 15, 10 Ventilation Rate換氣次數(shù) 16 Trauma in Children 10 per minute for adolescent 如為中童 , 10次 /分鐘 20 per minue for 1 year 如 1歲 , 20次 /分鐘 15 per minute for 1 year 如 1歲 , 15次 /分鐘 第十六頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 2024 Pearson Education, Inc., Upper Saddle River, NJ Breathing Management呼吸處理 17 Effective BVM ventilation— 有效 BVM換氣 intubation is Trauma in Children 第十七頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 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。 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。 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(yù)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 is awake 血循環(huán)衰竭的兒童仍可完全清醒 – Low blood pressure is sign of late ? BP 80 mmHg in child。 70 mmHg in young infant 20 Trauma in Children 第二十頁，共三十五頁。 Campbell,International Trauma Life Support, 6th Ed. 169。 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
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