静脉留置针在急诊护理中的使用

目的 探讨静脉留置针在急诊抢救中的使用,为危重患者的抢救赢得时间.方法 随机选取患者930例,分成观察组(470例,静脉留置针)和对照组(460例,一般一次性静脉输液针),在穿刺方法 、采集血标本、抢救时间、抢救成功率、患者满意等方面进行观察比较.结果 观察组的抢救成功率明显高于对照组.结论 在急诊抢救中留置针建立的静脉通道,能保证及时给药,提高转运的安全性,能同时采集血标本,减少重复穿刺率,提高护理工作效率,提高抢救成功率,为危重患者的抢救赢得时间.     

急性心肌梗塞的救护体会

急性心肌梗塞(AMI)是冠状动脉粥样硬化性心脏病的严重类型,抓紧时机,及时救治,可减少死亡率.我院近年来成功抢救了38例患者,无一例死亡.本文介绍了抢救措施,救护体会,强调心电监护,病情观察、心理及生活护理,以及护理人员应具备敏锐的观察力和预见性,还应加强对心电监护、中心静脉压及末梢循环的观察,并根据情况及时采取措施.对心脏骤停的病人采取心、肺、脑复苏的手段.具有熟练地基础理论和操作技术,给予准确及时的治疗.     

出血性休克急诊抢救的护理分析

目的:分析综合急救护理措施在出血性休克病人急诊抢救的作用.方法:回顾性分析2009年7月至2010年6月52例出血性休克病人的抢救护理配合过程,探讨综合急救护理措施的效果.结果:52例出血性休克病人中,22例(占42.3%)经急诊手术止血而纠正休克,另29例(占55.8%)经静脉补充血容量和药物止血后休克缓解,平均住院(留观)时间为4.9±1.7天,病人的满意度为98.1%,家属的满意度达100%.结论:在抢救过程中,护理人员默契配合、医护互补,落实综合急救护理措施,是出血性休克病人抢救成功的关键.     

164例严重多发伤患者的急救护理体会

目的:探讨急救护理在救治严重多发伤过程中的作用.方法:对164例严重多发伤患者给予保持呼吸道通畅、迅速补充血容量、及时处理活动性出血、持续监测生命体征、心理护理等急救护理措施.结果:本组164例患者采用手术治疗者131例(占79.88%)、非手术治疗33例(占20.12%),经治疗治愈136例(占82.93%),死亡28例(占17.03%).结论:给予严重多发伤患者相应的急救护理可为抢救赢得宝贵的时间,可有效的提高多发伤抢救的成功率.     

218例脑卒中患者的急救护理

总结218例脑卒中患者在急诊抢救中的护理要点,主要措施为生命体征监测、保持合适的卧位、吸氧、吸痰、保持呼吸道通畅和静脉输液通路通畅等.认为规范快速有效的急救护理措施对保全脑卒中患者生命、争取抢救时间、减少后遗症有重要意义.     

ICU深静脉导管留置中常见的护理问题及处理

静脉通道的建立及静脉输液在危重患者的救治中起着重要作用.深静脉置管输液不仅可避免反复穿刺给病人带来的痛苦、保护外周静脉的同时,为抢救病人、强刺激药物给药、肠外营养的及时给予等开放了一条快速、有效的静脉通道.在深静脉导管的应用过程中,导管的护理显得尤为重要,2008年10月1日至2009年10月1日,我科深静脉置管267例,现将使用中出现的护理问题及处理措施报告如下.     

急诊多发伤救治探析

目的 总结急诊多发伤患者的救治经验.方法 对我医院2008年～2010年急诊救治的多发伤患者258例的临床资料进行回顾性分析.结果 258例急诊多发伤患者急诊抢救,死亡31例,成功率88.37%,死亡率12.01%.结论 多发性的救治必须强调"准确、及时",严格按照"生命第一,器官第二,止血为先,修补在后"的原则,将多发伤的病死率和致残率最大限度的减小.     

慢性移植物抗宿主病致急性肺损伤患者的护理

分析了1例慢性移植物抗宿主病致急性肺损伤引起皮下、纵隔气肿患者的护理体会.认为为提高患者救治的成功率,临床配合与护理工作中应加强一般护理(休息、饮食、皮肤及心理护理)、严密观察病情、做好用药护理及间充质细胞输注过程中的护理、观察,其中以呼吸系统和气肿情况的观察、应用环孢素A的护理、间充质细胞输注的护理尤为重要.     

各种创伤急救患者静脉通道建立方式的调查

目的 了解医院急诊护士在各种创伤现场急救、途中转运、院内救治时使用不同方法进行静脉通道建立的现状,提出相应对策.方法采用自制的急诊护士使用不同方法进行静脉通道建立的情况调查表,主要调查各种建立静脉通道方法的优缺点,另外也让调查对象提出意见、建议.结果静脉留置针配合三通管建立静脉通道重注率和增加建立静脉通道率远低于单纯使用普通钢针或静脉留置针,差异有统计学意义(P<0.05).结论静脉留置针配合三通管建立静脉通道既避免护士反复穿刺而浪费时间,又方便给药,利于抢救,大大提高了医务人员的工作效率.     

急性心肌梗死的护理体会

目的:总结急性心肌梗死的护理经验.方法:除了做好常规的护理外,针对急性心梗患者的特殊心理特点,及时与其沟通,了解其心理状态并给予相应的心理疏导,做好家属的心理工作,严格执行探视制度,减少不良刺激,提高抢救成功率.结果:急性心肌梗死患者中,经抢救治疗和心理疏导安全度过危险期的58例,死亡4例.结论:在做好护理常规的基础上,重视患者及家属的心理疏导及加强探视制度的管理,能提高抢救成功率.     

Molecular biological intervention

Molecular biological intervention including gene therapy is a novel form of molecular medicine that will have an impact on the treatment of many serious diseases. Recent advancement in understanding of molecular mechanism of human disease and development of gene technology allows us practical approaches to molecular biological intervention. In addition to the possibility of correcting inherited genetic disorders, molecular biological intervention is being used to combat acquired disease. In the field of nephrology, the basic study has started on the gene transfer into the kidney in vivo. This review describes some approaches and methods that may be used for molecular biological intervention for glomerulonephritis and the state of our preclinical studies targeting transforming growth factor-beta.     

Diabetes intervention therapy

The effect on the middle cerebral artery blood flow velocity (VMCA) of moderate and hard physical exercise on an ergometer cycle was examined in 10 healthy volunteers using transcranial Doppler sonography (TCD). During exercise, the heart rate increased by 136% and the systolic blood pressure by 37% (mean values). During initial moderate exercise, VMCA increased by 51%; in a following period of maximal physical work, VMCA decreased again by 20% in 9 of 10 volunteers although the heart rate continued to increase by 10% and the systolic blood pressure by 5% (mean values). Constriction of the MCA may explain the initial increase of VMCA, suggesting a role for large cerebral arteries in autoregulation. Our data indicate that the subsequent decrease of VMCA is caused by arteriolar constriction, a likely cause of which was hyperventilation during the excessive work period.     

Coronary intervention 1996

BACKGROUND AND OBJECTIVES: This study sought to determine whether the number of alcohol-containing beverages consumed by adolescents attending a "typical" high school weekend party was planned or spontaneous. A second objective was to understand the role of the designated driver and whether he or she honored a pledge of sobriety. METHODS: A printed, anonymous survey with signed informed consent was distributed to 52 high school students from three different suburban high schools during three weekend high school parties. In addition, subjects underwent breath alcohol testing using the Intoximeter breath alcohol instrument. Salivary alcohol measurements were also obtained using Alco-Screen. Levels were measured in volunteers on entry and exit from the party. RESULTS: Fifty-two students volunteered to participate in the survey. Eleven participants volunteered to be designated drivers, nine of whom did not drink alcohol at this party. By the end of each party, the 26 boys had consumed a mean of 10 drinks, and the 16 girls had consumed 4.1 drinks, almost exactly what they had predicted at the time of arrival. By departure time, 22 (54%) of the drinkers had a breath alcohol value of .10 g/dL or greater, while only three (7%), had alcohol values of .02 g/dL or less. Blackouts were common and had been experienced by 73% of all the students surveyed. Twenty-seven percent of those surveyed had been involved in some form of physical violence while drinking. Eleven percent of the female participants reported being sexually assaulted while they or their attacker were drunk. Most of the 42 drinkers believed that it was acceptable for designated drivers to drink at least two beers. Two intoxicated designated drivers were driven home by sober friends. CONCLUSIONS: High school students in this study knew before attending a party the quantity of beer they would consume. Survey participants believed that it is acceptable practice for designated drivers to drink alcohol at parties; 13% of those who intended to drive after these parties were intoxicated.     

Therapeutic intervention and signaling

To examine the effects of rapid dehydration on isometric muscular strength and endurance, seven men were tested at baseline (control) and after a dehydration (dHST) and a euhydration (eHST) heat stress trial. The dHST consisted of intermittent sauna exposure until 4% of body mass was lost, whereas the eHST consisted of intermittent sauna exposure (same duration as dHST) with water replacement. Peak torque was determined for the knee extensors and elbow flexors during three isometric maximal voluntary contractions. Time to fatigue was determined by holding a maximal voluntary contraction until torque dropped below 50% peak torque for 5 s. Strength and endurance were assessed 3.5 h after the HSTs (no food or water intake). Body mass was decreased 3.8+/-0.4% post dHST and 0.4+/-0.3% post eHST. Plasma volume was decreased 7.5+/-4.6% and 5.7+/-4.4%, 60 and 120 min post dHST, respectively. A small (1.6 mEq x L[-1]) but significant increase was found for serum Na+ concentration 60 min post dHST but had returned to predehydration level 120 min post dHST. Serum K+ and myoglobin concentrations were not affected by HSTs. Peak torque was not different (P > 0.05) among control, dHST, and eHST for the knee extensors (Mean (Nm)+/-SD, 285+/-79, 311+/-113, and 297+/-79) and elbow flexors (79+/-12, 83+/-15, and 80+/-12). Time to fatigue was not different (P > 0.05) among control, dHST and eHST for the knee extensors (Mean (s)+/-SD. 42.4+/-11.5, 45.3+/-7.6, and 41.8+/-6.0) and elbow flexors (48.2+/-8.9, 44.0+/-9.4, and 46.0+/-6.4). These results provide evidence that isometric strength and endurance are unaffected 3.5 h after dehydration of approximately 4% body mass.     

Nurses in early intervention

The number of children from ages birth to 3 in need of early intervention services has increased over the past decades. A family-centered approach to early intervention services is essential. The family-centered approach emerged from early intervention philosophy developed by professionals in response to the needs of children and families. The historical perspective of early intervention and family-centered care, the role of nurses in early intervention and suggested focus of future research are outlined.