1 case of foreign body asphyxia rescue experience

yxfbbiedtj · Wysłany: Pią 17:27, 25 Mar 2011

1 case of asphyxia rescue experience of foreign body

Degree of hypoxia, cyanotic lips nails, pale and stopped breathing, weak pulse, cold extremities. Immediately to the cricothyroid membrane puncture, the symptoms were not relieved, the line bronchoscopy immediately, remove the high-lem, 0.6cm diameter cylindrical plastic whistle. Children still no spontaneous breathing, the mouth resuscitation can be Lamine 0.375g, Lobeline 3mg intramuscular injection, pressurized oxygen, dexamethasone 5mg, 25% glucose infusion 2Oral, about 5 minutes, spontaneous breathing gradually restored, emergency income homes. After admission to oxygen, 5% glucose 300ml, white ADM 4o million u, 5mg intravenous infusion of dexamethasone, - 4, hours after the recovery of consciousness, difficulty breathing response, and 4 days after the children are drowsiness, nausea, vomiting , the diagnosis of pediatric brain hypoxia caused by suffocation. Intravenous citicoline, energy mixture, vitamin C and other nutrients brain cells medicine, hyperbaric oxygen therapy, symptoms improved after two days of hospitalization were discharged l0 days. Preoperative Nursing Care 2.1 2: Prepare the first aid equipment, medicines, prepare cricothyroid membrane puncture, tracheotomy package, select a direct laryngoscopy, bronchoscopy, and with the support of various foreign forceps, suction devices, oxygen. 2.2 with the surgery and nursing care: ① position: supine position, the head was down like vertical, with the doctors raised the hands of the mirror in-depth, rotating head. ② Note vital signs, report to a doctor and do a good job for the rescue of cardiac arrest. ③ removal of foreign body immediately after the inspection is complete, with or without residues. 2.3 to enhance surgical care to prevent complications: ① general nursing: a. Children opened collar, belt, keep indoor air fresh, and adequate moisture, environmental forest medical information) 2004 Vol 3-4 2l quiet, to ensure rest. Reduce oxygen consumption, supine position, head to one side to prevent inhalation of tracheal secretions; b. Special care records to establish the rescue, to observe the heart and lung failure caused by suffocation symptoms; c. Good basic care, maintenance of cricothyroid membrane puncture site clean and admonished and discharged after treatment. ② specialist care: a. Do not neglect to take effect after the foreign body, to closely observe the ease or difficulty in breathing has increased, with or without postoperative complications, in particular the occurrence of laryngeal edema; b. Maintain airway patency, and still do a good job preparing tracheotomy (tracheostomy bedside bag placed in children); c. After brain cells to drugs such as nutrition, promote recovery of brain cells. ③ psychological care: Remove the foreign body by bronchoscopy, the most prone to laryngeal edema and subglottic edema, / bJI, becomes more apparent. Crying, agitation may further increase laryngeal edema, resulting in choking again, do nurses have to patiently explain the work to eliminate the fear of children, to be detailed in more gentle disposition, to reduce the pain, to avoid crying. 3 experience I believe that a longer time on the suffocation, severe hypoxia, postoperative complications to prevent the occurrence of cerebral hypoxia. Oxygen at the same time in the rescue, should give energy mixture, citicoline, cerebrolysin brain cells and other nutritional substances, do not wait until symptoms appear after brain treatment. ② to hyperbaric oxygen therapy as soon as possible so that children with cerebral hypoxia occurred 4 days after the performance, indicating a longer time due to asphyxia, systemic hypoxia, and most famous of cerebral hypoxia, resulting in cerebral edema and cerebral edema often in revival 2448 hours began to form, peaked at 45 days, if given within 24-48 hours after asphyxia hyperbaric oxygen treatment, rapid improvement of cerebral anoxia, cerebral edema, blocking development. ③ oxygen conditions may in time be analyzed to understand the in vivo oxygen levels and carbon dioxide retention in an effort to prevent cerebral hypoxia sequelae, provide treatment basis. 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