嚴重創(chuàng)傷病人的麻醉(1)-在線瀏覽
2025-02-21 02:40本頁面
【正文】 Such patients can rarely be saved. In the second peak, exsanguinations from vascular injuries causes death within a few hours without medical treatment. Inadequate or delayed shock resuscitation or surgical treatment leads to late death from infection, sepsis, or multian failure. 麻醉前準備 對于嚴重創(chuàng)傷病人，必須首先考慮其病情特點： ①病情緊急； ②病情嚴重； ③病情復雜； ④有劇烈疼痛； ⑤應一律視作 “ 飽胃 ” 病人，慎重處理。 復蘇是應優(yōu)先采取的措施。 I. Overview A. Perform visual scan of patient for obvious injures. B. Obtain history from prehospital personnel and patient（ if able） Ⅱ . Primary survey（ ascertain“ ABCDEs” ） A. Airway maintenance（ with cervical spine control） 1. Look for chest wall movements, retraction and nasal flaring 2. Listen for breath sound, stridor, and obstructed ventilation. 3. Feel for air movement B. Breathing（ give supplemental oxygen） 1. Determine whether ventilation is adequate 2. Inspect chest to exclude open pneumothorax, sucking chest wound, or flail segment 3. Ausculate for bilateral breath sounds 4. Provide assisted ventilation for ventilatory failure C. Circulation（ establish venous access） 1. Check peripheral pulses, capillary refill, and blood pressure 2. Obtain electrocardiogram 3. Grade shock according to vital signs 4. Correct hypovolemia and obtain blood samples D. Disability（ determine neurologic status） 1. Evaluate central function A： alert V： responds to vocal stimulus P： r
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