icu醫(yī)師的背景與專業(yè)優(yōu)勢-文庫吧資料
2024-10-06 00:52本頁面
【正文】 is required in addition to that needed for base specialty (usually anaesthesiology, pulmonology or general internal medicine). ? In Italy, only anaesthesiologists may legally practise ICM. Pulmonary medicine and (adult) critical care medicine in Europe Eur Respir J 2024。 19: 1202–1206 ? In some countries (. Scandinavia, UK), anaesthesiology has dominated ICM from its birth, whereas in others (. the Netherlands), the picture is changing. ICM can only be practised legally by anaesthesiologists ? As of March 2024, of the 2,332 members of the European Society of Intensive Care Medicine(ESICM), % counted anaesthesiology and % internal medicine. ? Approximately 53% of Society members spend 100% of their time practising ICM。 19: 1202–1206 ? There has been growing concern within theEuropean Respiratory Society (ERS) that pulmonary physicians are being less involved in the practise of intensive care medicine Thoracic Society (ATS) expanded its mission statement to include CCM and changed the name of its journal to the American Journal of Respiratory and Critical Care Medicine in 1994 ? intermediate dependency areas intermediate level of care between the general ward and the ICU, patients with chronic and acute on chronic pulmonary insufficiency and those requiring prolonged mechanical ventilatory support can be managed effectively， support patients with single an (. pulmonary) failure, providing an intermediate level of care 第二十四頁，共四十頁。 不同背景醫(yī)生的優(yōu)勢－－外科醫(yī)師 ? 有極強(qiáng)的臨床動手能力，在收治外科病人為主的 ICU工作，其操作能力游刃有余 ? 對以下疾病和相應(yīng)并發(fā)癥的處理有相當(dāng)?shù)墓α? ? 急性重癥胰腺炎、大血管病變、嚴(yán)重創(chuàng)傷、燒傷、和外科相關(guān)的膿毒癥等等 ? 缺陷：診療病情直奔主題，缺少分析 第二十三頁，共四十頁。 ? 注重分析、注重檢查、注重檢驗、注重鑒別診斷 ? 在處理以下危重癥時，應(yīng)有相當(dāng)?shù)墓Φ?: ? 急性呼吸功能不全、急性心功能不全 、急性心肌梗死、嚴(yán)重心率失常 、高血壓危象、急性腎功能不全 、嚴(yán)重水、電解質(zhì)紊亂，酸堿平衡失調(diào) 、急性中毒 、 DIC、甲亢危象、非酮癥性昏迷等 ? RICU/CCU/EICU/NICU 第二十一頁，共四十頁。 不同背景醫(yī)生的劣勢－－麻醉科醫(yī)師 ? 少與病人家屬打交道，缺乏相應(yīng)經(jīng)驗 ? 善于處理問題，但缺少發(fā)現(xiàn)問題的能力 (檢驗結(jié)果的研判、對影像學(xué)結(jié)果的研讀 ) ? 全局觀念、全身觀念有待提高 人無完人 金無足赤 第二十頁，共四十頁。 第十八頁，共四十頁。 邊緣學(xué)科憶念時，試驗探測動物試， 閱讀思維圖書室，猷懷往年辛酸事。 體外低溫心病醫(yī)，控制降壓可顯微， ? 監(jiān)測描記多變革，電子自控莫猜疑。 局麻普魯 *世紀(jì)初，硬外阻滯宜稱賀， 穿刺敏捷巧妙手，熟練觀摩思路寬。 編纂印刷事
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