Unconscious patients with severe traumatic brain i

ncycgdxhl · Wysłany: Śro 22:35, 02 Mar 2011

Unconscious patients with severe traumatic brain injury management enteral nutrition

. To be lost consciousness, conventional disinfection vulva vagina, cervical dilatation, suction line of house operation. Intraoperative propofol as needed to maintain 20 ~ 30mg effects of anesthesia to the end of surgery. 2 2.1 Observation and nursing care and abortion psychological remedy for contraceptive failure, due to trauma and possible complications, so many patients have concerns, fear of pain, fear, and nursing staff should be kind and friendly attitude towards patients , patiently and carefully in plain language interpretation of the relevant knowledge to explain painless, surgical success. Inform patients of pain and discomfort without surgery, no postoperative side effects. Establishment of a reliable nurse-patient relationship, eliminate fear, it is mental, physical best, pro-active with the surgery. 2.2 understand the history of preoperative preparation, with or without heart and lung, liver, 'an important organ of renal disease, with or without history of drug allergy and mental condition, measuring vital signs, body weight, to assess the tolerance of surgery and anesthesia, the surgeon and anesthetists to provide safe health information for reference. Inform patients before surgery 4 to 6 hours of fasting to prevent propofol drugs and surgical drainage to stimulate vomiting, choking, emptying the bladder, to prevent accidental injury and surgery of uterine contractions. Gather the emergency and frequently used drugs (such as epinephrine,[link widoczny dla zalogowanych], atropine,[link widoczny dla zalogowanych], dexamethasone, ephedrine, oxytocin, etc.) and first aid and common items (such as oxygen, laryngoscopy, endotracheal tube, face mask, easy breathing apparatus, oxygen tube suction tube,[link widoczny dla zalogowanych], suction, multi-function ECG, flow instrument package, etc.), bring it into a state of emergency. 2.3 Nursing home patients in the patient supine pillow cut to the right place, appropriate verbal communication with patients, comforting interpretation so as to relax the tension. Continuous ECG monitoring. Opening of a large forearm vein, properly fixed, the choice of 5% GS250ml to maintain intravenous access. Bound limbs, to prevent the induction of anesthesia and surgery involuntary physical activity appears to block venous access, influence surgical operation,[link widoczny dla zalogowanych], pollution and falling bed sterile trauma accidents. Open flow instrument package to be successful induction of anesthesia, underwent perineal vaginal washing, according to conventional procedures of abortion, compact with your doctor. Intraoperative observing closely and, if conditions change, with the anesthesiologist discretion. 2.4 The application of clinical observation continuous monitoring of multi-function monitor BP, HR, R, SPO2. Observed changes in vital signs, record the dose of propofol, anesthesia onset time, recovery time, physical activity surgery, bleeding, lower abdominal pain after waking,[link widoczny dla zalogowanych], and other complications were observed. 2.5 Postoperative care still needs close observation after vital signs and blood pressure changes in mind, observe the situation of vaginal bleeding. Qinghuan patient name, observe the emergence of a clear response to J, to be in patients with stable vital signs, determine their awareness and orientation on the environment back to normal, fully awake state of consciousness, the Rotary were observed under the operating table to bed rest. Note that vaginal bleeding and abdominal pain cases, the health education, detailed notes after this flow to guide selection of effective contraceptive methods. Encouraged to eat high-calorie, easy to digest food or drink hot liquids, regular observation with 1 to 2 hours, no dizziness, no pain condition before discharge. Results 306 patients with 3 patients (including 206 cases of P group, F group 100 patients) had no intraoperative awareness, the successful completion of surgery, bleeding 10 ~ 30ml, with no complications. After intravenous administration of loss of consciousness for 30 to 40 seconds; operation time was 5 to 10 minutes; end of surgery, recovery time is 3 to 5 minutes; surgery before treatment reduced blood pressure compared with 5 ~ 20mmHg; heart rate of 10 to 20 times / points. A case had dropped to 46 beats / min after intravenous atropine to 62 beats / min; respiratory rate 3 to 6 times / min; oxygen saturation 95 to 99%; all had transient apnea , 30S relief after all their own, no significant difference between the two groups. The amount of F propofol group (2.3.4-0.3mg/kg) was significantly less than the P group (3.3 ± 0.5mg/kg); the incidence of intraoperative limb F group (20%) was significantly lower than the P group (80%); tell abdominal pain after waking condition, F was no, P group of 8%. 4 Discussion painless abortion under general anesthesia or intravenous. Shall be provided with cardiopulmonary resuscitation equipment, anesthesia by the anesthesiologist, experienced doctors surgery, requiring doctors and nurse anesthetists closely with the work put in place adequate preoperative preparation, intraoperative with quick, accurate, and try to shorten the operation time. Good observation, in order to detect anomalies in time to give effective treatment to prevent complications, the surgery is safe and successful. Propofol is a new type of intravenous anesthetics with rapid onset, short duration, wake up quickly, and no sleepy feeling, directional capability is not affected, etc. [¨, a painless drug of choice. Propofol painless, anesthesia level